Abstract: FR-PO465
Partial Replantation Method for Managing Peritoneal Dialysis Catheter Damage and Infections
Session Information
- Home Dialysis - 1
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Ryou, Seyoung, The Catholic University of Korea Seoul St Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
- Kim, Hyung Duk, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)
- Kim, Yaeni, The Catholic University of Korea Seoul St Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
Background
The revised 2023 guidelines from the International Society for Peritoneal Dialysis (ISPD) emphasize salvage methods for treating refractory exit site infections (ESI) and tunnel infections (TI), preserving the existing catheter by manipulating only the outer cuff above the peritoneum, there by avoiding hemodialysis transfer. Here, we investigated the efficacy of the partial replantation technique.
Methods
In this retrospective study from January 2021 to December 2023 at a single center, we compared 9 patients undergoing salvage methods with 58 patients receiving de novo catheter insertion. Our evaluation included ESI, TI, peritonitis, and catheter dysfunction. The salvage technique involved distal cutting of the infected or mechanically impaired catheter and connecting a new one using a connector comprising a PD adaptor and transfer set [Figure1].
Results
During the study period, nine patients (four males, mean age 56 years) with an average PD duration of 66 months underwent the salvage technique. Post-replantation outcomes included, one ESI case (11.1%), one TI case (11.1%), three peritonitis cases (33.3%), and two catheter removals (22.2%). No procedural complications or catheter dysfunctions were observed. The control group experienced similar rates of ESI (10.3%), TI (1.7%), peritonitis (19.0%), catheter removal (12.1%), and catheter dysfunction (1.7%). Kaplan-Meier analysis demonstrated no significant differences in outcomes between the two groups (ESI; p=0.31, TI; p=0.094, peritonitis; p=0.84, catheter dysfunction; p=0.69, catheter removal; p=0.39) [Figure2].
Conclusion
This study confirms non-inferiority and effectiveness of the salvage technique compared to de novo for managing ESI, TI and mechanical impairment of the catheter.