COMPLICATIONS - INFECTIONS

C.K. Oh, S.U. Choi, J.H. Kim, D.K. Oh
Surgery, Ajou University School of Medicine, Suwon/KOREA

Body: Introduction : Although the perioperative use of preventive antibiotics has been popular because it may prevent bacterial infections following renal transplantation, it would increase the cost as well as increase the incidence of drug resistant micro-organism and adverse effects. The prophylactic effect of perioperative antibiotics has not been well compared with the cases which did not use perioperative antibiotic prophylaxis. We retrospectively compared the differences of infectious complications rates after kidney transplantation between the cases of routine use of antibiotics or not. Methods: We reviewed retrospectively 106 renal transplantations (cadaver donor 42 cases, living donor 64 cases) performed by one surgeon at Ajou university hospital, Korea from January, 2006 to December, 2008. They were divided into two groups : Group A (n= 41; 38.7%) included the patients without prophylactic antibiotics and Group B (n= 65; 61.3%) included the patients received prophylactic antibiotics. We analyzed the incidences of infectious complications within 1 month after renal transplantation. Results: There were 66 (62.3%) male patients and 40 (37.7%) female patients. In Group A, most patients (62 cases, 95.3%) used 1^st generation cephalosporin and added other antibiotics in cases of infections. There were 2 (1.8%) cases of wound infection , 1 case in Group A (1/64) and 1 case in Group B (1/39) but no significant difference. Bacteremia (3 cases, 2.8%), hematoma (1 cases, 0.9%) infection and urinary tract infection (2cases, 1.8%) occurred only in Group B. Pneumonia and central catheter related infection were not occurred in both Groups. There were no clinical correlation between recipient diabetes, vesico-ureteral reflex, ESRD duration, operation time and infectious complication. But CAPD patients had higher wound infection (2 cases, P=0.031) and urinary tract infection (2 cases, P=0.031). And donor infection affected recipient post transplantation bacteremia (1 cases, P=0.02). Conclusions: The results of this study demonstrate that prophylactic use of antibiotics do not make a difference in infectious complication rates although renal transplantation is clean-contaminated surgery. Limitation of our study is low infectious complication rates and small cohort. Further studies are needed to evaluate proper indication of prophylactic antibiotic use, especially CAPD patients and previous donor infection.

Disclosure: All authors have declared no conflicts of interest.