Preservation Fluid Cultures In Simultaneous Pancreas And Kidney Transplantation: 20 Years Of Experience.

Simultaneous pancreatic and kidney transplantation (SPK) improves survival and quality of life in patients with type 1 and 2 diabetes mellitus with renal failure. However, postoperative infections remain the main cause of morbidity and mortality, and the role of preservation fluid (PF) as a potential vector for microorganisms is not completely defined. There is limited evidence on the clinical relevance of positive cultures of PF in SPK. Objective: Evaluate the incidence and clinical relevance of microbial contamination of PF in SPK with complications. Materials and methods: A retrospective study of 163 patients submitted to SPK was conducted. Microbiological PF cultures were analyzed, classifying the isolates as pathogens or contaminants. The association between positive cultures and postoperative complications was evaluated by multivariate statistical analysis. Results: 35% of the PFs were positive, with 24% pathogenic isolations. No evaluation was found between positive cultures and infectious complications (p=0.49), pancreatic (p=0.58) or renal (p=0.16). There was no impact on hospital stay (p=0.54) or on the rejection rate of Graff. Conclusion: Despite the detection of microorganisms in the PF, there is no evidence of clinical impact on postoperative results. This is the first large-scale SPK study to our knowledge that questions the need to modify current antibiotic management protocols. Prospective studies are needed to define whether the identification of pathogens in PF justifies changes in therapy.