Outcomes after Peripancreatic Fluid Drainage in Patients with Simultaneous Pancreas-Kidney Transplantation

J Vasc Interv Radiol. 2019 Jun;30(6):918-921. doi: 10.1016/j.jvir.2018.10.030. Epub 2019 Apr 11.

Abstract

Purpose: To determine the clinical outcomes of patients who underwent image-guided drainage of peripancreatic fluid collections after simultaneous pancreas-kidney (SPK) transplantation.

Materials and methods: A retrospective review of all patients who underwent peripancreatic fluid collection drainage after SPK, from January 2000 to August 2017, at a single institution was performed. Patient characteristics, surgical technique, medication regimen, microbial analysis, and clinical outcomes were reviewed. Thirty-one patients requiring a total of 41 drainages were included in this study. The median age was 44 years (range 30-58 years), and median time between SPK and drainage was 28 days (range 8 to 3,401 days). Fisher's exact test, unpaired Student t-tests, and Pearson correlations were used for statistical analysis.

Results: Fever (51%) and abdominal pain (31%) were the most common presenting symptoms. The average amount of fluid drained at the time of drain placement was 97 mL (SD 240 mL). The average time spent with a drain in place was 33 days (SD 31 days). Microorganisms were isolated in the fluid of 22 of 41 drainages (54%), with mixed gastrointestinal flora being the most common. No further intervention was needed in 34 of 41 drainages (82%). However, drainage failed in 5 of 31 patients (16%), requiring surgical intervention with removal of the pancreas transplant.

Conclusions: Percutaneous drainage of peripancreatic fluid collections after SPK transplantation is a safe and effective treatment option.

MeSH terms

  • Adult
  • Drainage / adverse effects
  • Drainage / instrumentation
  • Drainage / methods*
  • Female
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Pancreas Transplantation / adverse effects*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome