Incremental Value of the Pancreas Allograft to the Survival of Simultaneous Pancreas-Kidney Transplant Recipients

• Published in: Diabetes care Vol. 32; no. 4; pp. 600 - 602
• Main Authors: Salvalaggio, Paolo R, Dzebisashvili, Nino, Pinsky, Brett, Schnitzler, Mark A, Burroughs, Thomas E, Graff, Ralph, Axelrod, David A, Brennan, Daniel C, Lentine, Krista L
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-04-2009
• Subjects: Adult; Biological and medical sciences; Databases, Factual; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Follow-Up Studies; Graft Survival; Humans; Kidney Transplantation - mortality; Kidney Transplantation - physiology; Mathematical functions; Medical research; Medical sciences; Medicine, Experimental; Metabolic diseases; Miscellaneous; Mortality; Organ transplant recipients; Original Research; Pancreas Transplantation - mortality; Pancreas Transplantation - physiology; Patient outcomes; Postoperative period; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression analysis; Retrospective Studies; Studies; Survival Analysis; Survivors; Time Factors; Transplantation, Homologous; Transplants & implants; Treatment Failure; Young Adult; Human; Nutrition; Homograft; Metabolic diseases; Transplantation; Homotransplantation; Survival; Kidney; Treatment; Urinary system; Surgery; Graft; Pancreas; Endocrinology
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc08-1718

OBJECTIVE: To quantify the incremental survival benefit of the pancreas allograft in simultaneous pancreas-kidney (SPK) transplant recipients. RESEARCH DESIGN AND METHODS: Data from the national transplant database from 2000 to 2007 were analyzed. SPK recipients who had functioning allografts to 1-year post transplant (n = 3,304) were compared with those who had failure of the renal (n = 233) or pancreatic (n = 112) graft. The main outcome was a projection of 10 life-years of patient survival beyond the first transplant anniversary. RESULTS: Recipients with function of both organs accrued 9.4 life-years following transplantation. Projected survival in patients with kidney failure was reduced to 2.5 life-years. Pancreas failure reduced predicted survival to 8 life-years. Renal allograft failure impacts life expectancy significantly (adjusted hazard ratio [aHR] 12.13). However, pancreas allograft failure was also associated with reduced survival (aHR 2.62). CONCLUSIONS: Although the majority of the survival benefit of SPK transplant is due to the renal transplant, pancreas allograft function does contribute to patient survival.