Incidence of minor and major amputations after pancreas/kidney transplantation

• Published in: Transplant international Vol. 16; no. 2; pp. 128 - 132
• Main Authors: Woeste, Guido, Wullstein, Christoph, Pridöhl, Olaf, Lübke, Peter, Schwarz, Rene, Kohlhaw, Kay, Bechstein, Wolf O.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.02.2003; Blackwell Publishing
• Subjects: Adult; Amputation - statistics & numerical data; Amputation Dialysis; Biological and medical sciences; Combined surgery. Multiple transplantations; Diabetic Angiopathies - epidemiology; Diabetic Angiopathies - surgery; Female; Humans; Incidence; Islets of Langerhans Transplantation - statistics & numerical data; Kidney Transplantation; Kidney Transplantation - statistics & numerical data; Male; Medical sciences; Middle Aged; Pancreas; Peripheral Vascular Diseases - epidemiology; Peripheral Vascular Diseases - surgery; Postoperative Complications - epidemiology; Postoperative Complications - surgery; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Human; Amputation Dialysis; Hemodialysis; Transplantation; Kidney Transplantation; Homotransplantation; Long term; Kidney; Incidence; Extrarenal dialysis; Combined surgery; Surgical amputation; Surgery; Limb; Risk factor; Complication; Pancreas
• ISSN: 0934-0874; 1432-2277
• DOI: 10.1111/j.1432-2277.2003.tb00274.x

Among other complications, diabetes mellitus leads to peripheral vascular disease with the risk of limb amputation. This retrospective study analyzed the incidence of amputations after simultaneous pancreas‐kidney transplantation (SPK). Between June 1994 and February 2001, 200 SPKs, nine pancreas‐after‐kidney‐(PAK) and one pancreas transplantation alone (PTA) were performed. The overall 5‐year patient, pancreas‐, and kidney‐graft survival rates were 92.4%, 80.2% and 85.6%, respectively. Mean age at transplantation was 38.7 years, mean duration of diabetes was 26.9 years, mean duration of dialysis was 26.7 months. Nineteen (9.5%) patients after SPK (seven female/12 male) underwent 33 amputations, on average 18.7 months after transplantation. Longer duration of dialysis and a previous history of amputation were significant risk factors for an amputation after SPK (P=0.014, P<0.001). Thus, early referral for SPK before dialysis initiation may be beneficial in preventing amputation.