Early Bacterial Infections in Simultaneous Kidney and Pancreas Transplantation: Impact of Preservation Fluid Contamination

Contamination of preservation fluid (PF) has been associated with donor-transmitted infection in renal transplantation. Despite the infectious morbidity in simultaneous kidney-pancreas transplantation (SPKT), the role of PF contamination has never been reported. The aim of the study was to analyse the impact of PF contamination in bacterial infections of SPKT recipients. We retrospectively analysed 75 SPKT performed in our centre, whose PF were systematically analysed. Our analysis focused on the first bacterial infectious episode in the three months post transplantation. A multivariate cox survival model was used to determine the impact of contaminated PF on infection risk. A total of 30/75 (40%) patients presented at least one infection. Three month infection incidence was 6.6 per 1000 patient-day. Infection sites were mostly intra-abdominal and urinary (30% and 26.7%, respectively). The bacteria that caused the infection were mostly of digestive origin (44.4%). PF cultures were positive in 47 (62.7%) patients. In multivariate analysis, only pancreatic fistula were significantly associated with early bacterial infection (HR = 3.95, IC 95% [1.66-9.04], p = 0.002). No association was found between positive PF and early bacterial infection (HR = 0.99 IC 95% [0.47-2.08], p = 0.97). In SPKT, positive PF did not have an impact on early bacterial infections; the main risk factor was post transplant pancreatic fistula.