MORBIDITY AFTER RE-TRANSPLANTATION OF KIDNEY AND/OR PANCREAS AT ROSTOCK UNIVERSITY HOSPITAL

Abstract

P419 Aims: A. re-transplantation of kidney and/or pancreas is practicated to give the patient the quality of life back. The simultaneous pancreas-kidney transplantation is an operation with high risk, so the re-transplantation is an intervention with highest surgical and immunological risk and it is also a great challenge for the surgeon and his team. Methods: Between 06/1995-04/2004 135 transplantations were performed at Rostock University Hospital (110 simultaneous pancreas-kidney transplantations, 7 transplantation of pancreas alone, 18 re-transplantations). A retrospective study was performed to investigate the morbidity after re-transplantations. Parameters included the rates of re-laparotomy, septic complications, graft function and graft rejection. Results: We performed a total of 18 re-transplantations with 2 transplantations of pancreas alone after transplantation of kidney (PAK), 3 transplantations of pancreas after transplantations of pancreas alone (2. PA), 7 transplantations of pancreas after simultaneous pancreas-kidney transplantations (PASPK), 2 re-transplantations of pancreas and kidney (2.SPK), 3 transplantations of kidney after simultaneous pancreas-kidney transplantations (KASPK) and 1 simultaneous pancreas-kidney transplantation after kidney transplantation alone (SPKAK). Re-laparotomies were necessary in 9 patients because of pancreatitis (2), bleeding (6) and thrombosis of pancreas graft (2). Septic complications occurred in 6 patients with wound infections (3), infections of the urinary tract (2), pneumonia (1) and intraabdominal abscess (2). Episodes of acute graft rejections were observed in 5 patients with graft loss in 1 patient. Two patients lost there grafts because of thrombosis. Conclusions: A re-transplantation of pancreas and/or kidney is associated with higher peri- and postoperative morbidity than the simultaneous pancreas-kidney transplantation. The rate of relaparotomie with 50% in compare to 18-30% after first transplantation, the rate of graft thrombosis with 11% in compare to 5-8% after first transplantation, the occurrence of acute graft rejections with 27% in compare to 18% after first transplantation are clearly higher.