Outcomes of Pancreas Transplant Patients Undergoing Appendectomy

Abstract

Introduction: This study analyzes differences between pancreas transplant patients and non-transplant patients undergoing appendectomy in transplant and non-transplant centers to identify areas of surgical risk. Methods: Multivariate logistic regression tests and linear regression tests computed odds ratios (OR) by analyzing weighted data from the National Inpatient Sample database from 2005-2014 to identify differences in mortality, complications, length of stay (LOS), and total hospital charges between 4 patient groups 1)pancreas transplant alone (PTx) 2)kidney transplant alone (KTx), 3)pancreas and kidney transplant (PKTx), and 4)non-transplant patients (non-Tx) undergoing appendectomy for the diagnosis of appendicitis in transplant and non-transplant centers. Results: Of the 1,819,283 appendectomy procedures, 145 pancreas transplant patients were identified. No mortalities occurred among pancreas transplant patients. On univariate analysis, pancreas transplant patients had higher complication rates compared to non-transplant patients (17.0% vs 10.0%, p=0.012). On multivariate analysis, PKTx demonstrated a decreased odds ratio for developing any complication (OR 0.343; p0.003) compared to non-Tx. This was not observed in PTx or KTx. In transplant centers, PKTx (OR 0.196; p=0.002) and KTx (OR 0.461; p< 0.001) demonstrated significantly decreased odds ratios for developing any complication. In transplant centers, there were no significantly higher odds ratios for LOS or total charges in PTx or PKTx groups. Conclusion: PKTx were less likely to develop a complication when undergoing an appendectomy. In transplant centers, PKTx and KTx were both less likely to develop a complication. It appears pancreas transplant patients undergoing appendectomy are not at higher risk for complications compared to the general population.