ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO2516

When a Peritoneal Dialysis Catheter Should Be Removed Post-Kidney Transplantation?

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Katz-Greenberg, Goni, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Yadav, Anju, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Singh, Pooja, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
Background

Approximately 15% of patients on the kidney transplant (KT) waiting list in the US receive peritoneal dialysis (PD), a growing home dialysis therapy for end stage renal disease (ESRD) patients. . European guidelines recommend keeping the peritoneal dialysis catheter (PDC) in-situ during KT, due to the potential risk for delayed graft function (DGF). With this approach, a 10% risk for post-transplant PDC exit-site infections has been reported. In the US guidelines for l PDC removal timing are lacking, and determine by transplant center and operating surgeon’s preferences.

Methods

We retrospectively reviewed the electronic medical records of all patients transplanted between 4/2017-7/2019 at our kidney transplant center. We studied basic donor and recipient characteristics, presence of DGF (defined as dialysis in the first week following KT), time interval between KT and PDC removal, and wound related complications.

Results

Of 259 patients received a KT during the study period, 28 were on PD prior to KT. Of those 10patients underwent a living donor transplant, 16had a deceased donor, and 2underwent a simultaneous kidney-pancreas transplant. Sixteen were female, 9were non-Hispanic blacks, and 4were aged >65 years. Three received induction with basiliximab (per center’s protocol for recipients aged ≥70 years) and the rest received antithymocyte globulin.
PDC was removed at time of KT in 17 patients while in the other 11 recipients PDC was removed 22 days (median) post transplantation. For patients developed DGF, with modality switched to hemodialysis. Three of these had their PDC removed at the time of KT. The 4th patient with DGF who had his PD catheter left in place, received hemodialysis due to hemodynamic instability. Readmission rates (excluding planned hospitalization for PDC removal) and wound infections were similar between Those who had their PDC removed at surgery, and those who did not.

Conclusion

Kidney transplant centers that do not routinely use PD for DGF should remove the PDC at time of kidney transplant to reduce costs and prevent patient and healthcare provider burden of additional surgery. As the prevalence of PD and KT is expected to grow in the near future with the new kidney health initiatives, kidney transplant centers should consider a protocol for optimal care for PDC removal.