Impact of pre-transplant dialysis modality on the outcome and health-related quality of life of patients after simultane
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(2020) 18:303
RESEARCH
Open Access
Impact of pre-transplant dialysis modality on the outcome and health-related quality of life of patients after simultaneous pancreas-kidney transplantation Uwe Scheuermann1 , Sebastian Rademacher1, Nora Jahn2, Elisabeth Sucher3, Daniel Seehofer1, Robert Sucher1† and Hans-Michael Hau1,4*†
Abstract Background: Simultaneous pancreas-kidney transplantation (SPKT) profoundly improves the health-related quality of life (HRQoL) of recipients. However, the influence of the pre-transplant dialysis modality on the success of the SPKT and post-transplant HRQoL remains unknown. Methods: We analyzed the surgical outcome, long-term survival, as well as HRQoL of 83 SPKTs that were performed in our hospital between 2000 and 2016. Prior to transplant, 64 patients received hemodialysis (HD) and nineteen patients received peritoneal dialysis (PD). Physical and mental quality of life results from eight basic scales and the physical and mental component summaries (PCS and MCS) were measured using the Short Form 36 (SF-36) survey. Results: Peri- and postoperative complications, as well as patient and graft survival were similar between the two groups. Both groups showed an improvement of HRQoL in all SF-36 domains after transplantation. Compared with patients who received HD before transplantation, PD patients showed significantly better results in four of the eight SF-36 domains: physical functioning (mean difference HD - PD: − 12.4 ± 4.9, P = < 0.01), bodily pain (− 14.2 ± 6.3, P < 0.01), general health (− 6.3 ± 2.8, P = 0.04), vitality (− 6.8 ± 2.6, P = 0.04), and PCS (− 5.2 ± 1.5, P < 0.01) after SPKT. In the overall study population, graft loss was associated with significant worsening of the HRQoL in all physical components (each P < 0.01). Conclusions: The results of this analysis show that pre-transplant dialysis modality has no influence on the outcome and survival rate after SPKT. Regarding HRQoL, patients receiving PD prior to SPKT seem to have a slight advantage compared with patients with HD before transplantation. Keywords: Health-related quality of life, Hemodialysis, Outcome, Peritoneal dialysis, Simultaneous pancreas-kidney transplantation, Survival
* Correspondence: [email protected] † Robert Sucher and Hans-Michael Hau both authors contributed equally to this work and share senior authorship 1 Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany 4 Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany Full list of author information is available at the end of the article
Introduction Simultaneous pancreas-kidney transplantation (SPKT) offers considerable survival benefits for patients with insulindependent diabetes mellitus and end-stage renal disease (ESRD), because it restores long-term glycemic control and can reduce secondary diabetic complications [1–6]. Due to organ shortag
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