Deep wound infections in simultaneous pancreas-kidney transplant recipients on peritoneal dialysis

Peripancreatic abscess formation remains an important cause of surgical morbidity following simultaneous pancreas-kidney (SPK) transplants. The purpose of this study is to define the association, if any, between the pretransplant method of dialysis and the incidence of peripancreatic abscess formation. We reviewed 57 bladder-drained SPK transplants. Of these, 42 were on haemodialysis (HD) and 15 on peritoneal dialysis (PD) prior to transplantation. Two grafts were lost and three patients died as a result of peripancreatic infections for a total graft loss of 8.8%. The incidence of this complication was higher (P = 0.036 Pearson chi square) in patients on PD (40%) prior to transplant when compared to patients on HD (14%). The most common organism cultured from the abscesses was Staphylococcus epidermidis in both groups. Impairment of peritoneal macrophage function and accumulation of peritoneal effluent as a result of altered peritoneal membrane function are some of the changes that occur following chronic peritoneal dialysis and could explain our findings.