Early oral feeding vs. traditional oral feeding in patients undergoing simultaneous pancreas and kidney transplantation: a single-center randomized controlled trial

Background: Currently, there is no evidence on the timing of oral feeding, nor is there a feeding protocol post simultaneous pancreas-kidney transplantation (SPKT).Methods: A total of 70 patients who underwent SPKT were randomly divided into 2 groups: (I) the early oral feeding (EOF) group (n=35) and (II) the traditional oral feeding (TOF) group (n=35). In the EOF group, the nasogastric tube was removed and oral feeding began on day 5 after SPKT. Conversely, in the TOF group, the date was delayed to postoperative 7 th. The differences in body weight, nutritional indexes, the incidence of perioperative complications, the length of stay (LOS), and total hospital costs were compared between the 2 groups before surgery, and 1, 2, and 3 weeks after surgery. All patients have completed the follow up.Results: There were no significant differences between these 2 groups in terms of the baseline data, and the total hospital costs/the LOS (all P>0.05). Additionally, there were no statistically significant differences in terms of weight ( 64.47 +/- 7.77 vs. 65.70 +/- 10.49 kg, 64.62 +/- 7.61 vs. 65.94 +/- 10.46 kg, 65.59 +/- 7.71 vs. 65.96 +/- 9.84 kg, P>0.05) and serum albumin (44.40 +/- 5.77 vs. 43.49 +/- 5.47 g/L, 41.11 +/- 5.38 vs. 41.56 +/- 5.60 g/L, 39.39 +/- 4.74 vs. 39.84 +/- 5.17 g/L, P>0.05) between these 2 groups before surgery, and 1, 2, and 3 weeks after surgery. The incidences of gastrointestinal bleeding (n=4 vs. n=12) and pulmonary infection (n=3 vs. n=12) were significantly lower in the EOF group than the TOF group, and there was no significant difference in the incidence rates of gastrointestinal adverse effects (e.g., recurrent bloating, diarrhea, and nausea/vomiting), and postoperative complications (e.g., anastomotic leakage, pancreatic leakage, intestinal obstruction, abdominal infection, acute rejection, delayed graft function, urinary retention, incisional infection, and urinary tract infection) (all P<0.05).Conclusions: EOF is safe and tolerable in patients undergoing SPKT. Additionally, it effectively lowers the incidence of gastrointestinal bleeding and pulmonary infections.