Introduction: Pancreas transplantation (PT) shows a higher rate of complications compared with other organ transplantations. Graft thrombosis and intraabdominal infections are the most common causes for relaparatomy. We analyzed the influence of complications on the organ function after PT.
Methods: 145 pancreas grafts were transplanted between 01/2010 and 12/2015 at our hospital with 132 simultaneous pancreas-kidney transplantations, 5 isolated pancreas transplantations and 8 pancreas after kidney transplantation. Out of this, 16 were retransplantations. A further analyzation was done for 132 of these transplants.
Results: Complications occurred in 72 of 132 patients (54,55%). Pancreatitis (n=53), pancreatic fistulas (n=33) and postoperative bleeding (n=24) were most commonly observed. A relaparatomy was required for every third patient, mainly because of infectious reasons as abscess and pancreatitis. 22 pancreas transplants and 14 kidney transplants lost their function shortly after transplant. Until 05/2017 68,18 % of the pancreas and 78,03 % of the kidney transplants are full functional.
Complications had an significant influence on the organ function after PT (p=7.046e-05). Operative revision (p=0,0009), pancreatitis (p=0,0114), bleeding (p=0,0045) and graft thrombosis (p=0,0054) showed statistical significant influence on the pancreas graft function after transplantation. Rejection (p=0,1778) , pancreatic fistulas (p = 0,0843) and CT-drainage (p=0,8088) demonstrated no further influence.
Our data showed no correlation between the occurrence of complications and donor or recipient variables (e.g. BMI, age). Neither had the ischemia time nor the operation duration or the presence of positive germ wraps any significant influence.
Conclusion: Complication rates are still high in PT and affect the function of the pancreas graft significant. Strategies to reduce postoperative pancreatitis and infections need to be further investigated.