Cholecystectomy Outcomes in Pancreas-kidney Transplant Recipients Compared to Kidney or Pancreas Transplant Alone Recipients

Abstract

Introduction: Previous studies have demonstrated that kidney transplant recipients have greater risk for all cause morbidity and mortality when undergoing cholecystectomy. However, cholecystectomy following pancreas transplantation has not been previously studied. Methods: In a total 3738229 cholecystectomies performed in the United States between 2005-2014. There were 600 cholecystectomies performed in pancreas transplant recipients. There were 57.1 White patients and 36.2% male patients. There were 58.5% male pancreas transplant patients and 72.2% White pancreas transplant patients. 75% of pancreas transplant patients received their cholecystectomy at a transplant center. Results: Pancreas transplant alone was associated with a significantly higher odds ratio for developing any complication (3.158, p< 0.001). Simultaneous kidney pancreas transplant was not significantly different compared with the general population. (P 0.787). At transplant centers, odds ratio for complications for PTA was significantly higher than at non transplant centers (OR 1.748 P 0.025). Discussion/Conclusion: The results of this study differs from previously published materials. While the PTA results are consistent with previously published data showing that transplant recipients are at higher risk for morbidity and mortality when undergoing cholecystectomies, the SPK results showing no difference are unique. This may indicate that factors beyond obligate immunosuppression are causative and require further investigation. Higher rates of complications at transplant centers may be reflective of common practice patterns where patients with greater disease severity and complexity are transferred to specialized quaternary care transplant centers, rather than treated in the community setting.