Should peritoneal dialysis catheters be removed at the time of kidney transplantation?

Authors

  • Jeff Warren Multiorgan Transplant Program, London Health Sciences Centre, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON
  • Emily Jones Multiorgan Transplant Program, London Health Sciences Centre, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON
  • Alp Sener Multiorgan Transplant Program, London Health Sciences Centre, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON
  • Martin Drage Multiorgan Transplant Program, London Health Sciences Centre, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON; and the University Department of Surgery, Addenbrooke’s Hospital and the NIHR Cambridge Biomedical Research Centre, Cambridge, UK
  • Ali Taqi Multiorgan Transplant Program, London Health Sciences Centre, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON
  • Sian Griffin University Department of Surgery, Addenbrooke’s Hospital and the NIHR Cambridge Biomedical Research Centre, Cambridge, UK
  • Christopher Watson University Department of Surgery, Addenbrooke’s Hospital and the NIHR Cambridge Biomedical Research Centre, Cambridge, UK
  • Patrick P. W. Luke Multiorgan Transplant Program, London Health Sciences Centre, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON

DOI:

https://doi.org/10.5489/cuaj.14

Abstract

Background: Delayed graft function (DGF) following transplantationnecessitates support in the form of hemodialyis (HD) orperitoneal dialysis (PD). However, post-transplant PD-related complicationand failure rates are unknown.

Methods: We studies patients who were on PD at the time of kidneytransplantation over a 4-year period at two separate institutions.

Results: Of the 137 PD patients, 19 had their catheters removedat the time of transplant. Of the remaining 118 patients, 89% hadimmediate graft function. PD-related complications in this groupincluded peritonitis (n=5), catheter-related infections (n=2) andemergency laparotomy (n=1). Of the 15 patients requiring posttransplantPD, 33% developed peritonitis and 20% had fluid-leaksnecessitating HD. Overall, leaving a PD catheter in situ post- transplantationis associated with 7% rate of peritonitis versus 0% ifremoved (p < 0.05).

Conclusions: PD catheter removal should be considered at thetime of renal transplantation, as postoperative PD-related failure/complication rates are high.

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References

Dombros N, Dratwa M, Feriani M, et al. European best practice guidelines for peritoneal dialysis. 3 Peritoneal access. Nephrol Dial Transplant 2005;20:ix8-ix12.

Arbeiter K, Pichler A, Muerwald G, et al. Timing of peritoneal dialysis catheter removal after pediatric renal

transplantation. Perit Dial Int 2001;21:467-70.

Andreetta B, Verrina E, Sorino P, et al. Complications linked to chronic peritoneal dialysis in children after kidney transplantation: experience of the Italian Registry of Pediatric Chronic Peritoneal Dialysis. Perit Dial Int 1996;16:S570-3.

Palmer JA, Kaiser BA, Polinsky MS, et al. Peritoneal dialysis catheter infections in children after renal transplantation: choosing the time of removal. Pediatr Nephrol 1994;8:715-8.

Chalem Y, Ryckelynck JP, Tuppin P, et al. Access to, and outcome of, renal transplantation according to treatment modality of end-stage renal disease in France. Kidney Int 2005;67:2448-53.

Gokal R, Kost S. Peritoneal dialysis immediately post transplantation. Adv Perit Dial 1999;15:112-5.

Bakir N, Surachno S, Sluiter WJ, et al. Peritonitis in peritoneal dialysis patients after renal transplantation.

Nephrol Dial Transplant 1998;13:3178-83.

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Published

2012-11-15

How to Cite

Warren, J., Jones, E., Sener, A., Drage, M., Taqi, A., Griffin, S., Watson, C., & Luke, P. P. W. (2012). Should peritoneal dialysis catheters be removed at the time of kidney transplantation?. Canadian Urological Association Journal, 6(5). https://doi.org/10.5489/cuaj.14

Issue

Vol. 6 No. 5 (2012): CUAJ October

Section

Original Research

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