BACKGROUND: Early pancreas graft failure after simultaneous pancreas and kidney (SPK) transplantation is common. We studied the impact of early pancreas graft failure on long-term kidney and patient survival. METHODS: We included all primary SPK transplants performed in the United States between January 1, 2000, and December 31, 2007, who had maintained kidney graft function at 90 days posttransplantation. Kaplan-Meier and Cox multivariate analyses were performed. The causes of death between the two cohorts were compared. RESULTS: A total of 6282 SPK recipients were included in the analyses. Of those, 470 had lost pancreas graft within the first 90 days largely related to pancreas graft thrombosis. Early pancreas graft failure was associated with lower subsequent kidney graft and patient survival (log-rank, P=0.02 and P<0.001, respectively). Multivariate regression analyses demonstrated a 70% higher risk of kidney graft failure after 3 years (adjusted hazard ratio 1.69; 95% CI 1.08, 2.66; P=0.022) and more than doubled the risk for death (adjusted hazard ratio 2.18; 95% CI 1.67, 2.85; P<0.001) among SPK recipients with early pancreas graft failure. The causes of death were similar between the two cohorts. CONCLUSION: Early pancreas graft failure in SPK transplant recipients is associated with an increased risk for subsequent kidney failure and death. Optimization of therapeutic interventions after early pancreas graft failure is needed.
BACKGROUND: Early pancreas graft failure after simultaneous pancreas and kidney (SPK) transplantation is common. We studied the impact of early pancreas graft failure on long-term kidney and patient survival. METHODS: We included all primary SPK transplants performed in the United States between January 1, 2000, and December 31, 2007, who had maintained kidney graft function at 90 days posttransplantation. Kaplan-Meier and Cox multivariate analyses were performed. The causes of death between the two cohorts were compared. RESULTS: A total of 6282 SPK recipients were included in the analyses. Of those, 470 had lost pancreas graft within the first 90 days largely related to pancreas graft thrombosis. Early pancreas graft failure was associated with lower subsequent kidney graft and patient survival (log-rank, P=0.02 and P<0.001, respectively). Multivariate regression analyses demonstrated a 70% higher risk of kidney graft failure after 3 years (adjusted hazard ratio 1.69; 95% CI 1.08, 2.66; P=0.022) and more than doubled the risk for death (adjusted hazard ratio 2.18; 95% CI 1.67, 2.85; P<0.001) among SPK recipients with early pancreas graft failure. The causes of death were similar between the two cohorts. CONCLUSION: Early pancreas graft failure in SPK transplant recipients is associated with an increased risk for subsequent kidney failure and death. Optimization of therapeutic interventions after early pancreas graft failure is needed.
Authors: Jackson T Wright; George Bakris; Tom Greene; Larry Y Agodoa; Lawrence J Appel; Jeanne Charleston; DeAnna Cheek; Janice G Douglas-Baltimore; Jennifer Gassman; Richard Glassock; Lee Hebert; Kenneth Jamerson; Julia Lewis; Robert A Phillips; Robert D Toto; John P Middleton; Stephen G Rostand Journal: JAMA Date: 2002-11-20 Impact factor: 56.272
Authors: T H Jafar; C H Schmid; M Landa; I Giatras; R Toto; G Remuzzi; G Maschio; B M Brenner; A Kamper; P Zucchelli; G Becker; A Himmelmann; K Bannister; P Landais; S Shahinfar; P E de Jong; D de Zeeuw; J Lau; A S Levey Journal: Ann Intern Med Date: 2001-07-17 Impact factor: 25.391
Authors: L Y Agodoa; L Appel; G L Bakris; G Beck; J Bourgoignie; J P Briggs; J Charleston; D Cheek; W Cleveland; J G Douglas; M Douglas; D Dowie; M Faulkner; A Gabriel; J Gassman; T Greene; Y Hall; L Hebert; L Hiremath; K Jamerson; C J Johnson; J Kopple; J Kusek; J Lash; J Lea; J B Lewis; M Lipkowitz; S Massry; J Middleton; E R Miller; K Norris; D O'Connor; A Ojo; R A Phillips; V Pogue; M Rahman; O S Randall; S Rostand; G Schulman; W Smith; D Thornley-Brown; C C Tisher; R D Toto; J T Wright; S Xu Journal: JAMA Date: 2001-06-06 Impact factor: 56.272
Authors: Stephen T Bartlett; James F Markmann; Paul Johnson; Olle Korsgren; Bernhard J Hering; David Scharp; Thomas W H Kay; Jonathan Bromberg; Jon S Odorico; Gordon C Weir; Nancy Bridges; Raja Kandaswamy; Peter Stock; Peter Friend; Mitsukazu Gotoh; David K C Cooper; Chung-Gyu Park; Phillip OʼConnell; Cherie Stabler; Shinichi Matsumoto; Barbara Ludwig; Pratik Choudhary; Boris Kovatchev; Michael R Rickels; Megan Sykes; Kathryn Wood; Kristy Kraemer; Albert Hwa; Edward Stanley; Camillo Ricordi; Mark Zimmerman; Julia Greenstein; Eduard Montanya; Timo Otonkoski Journal: Transplantation Date: 2016-02 Impact factor: 4.939
Authors: J P Lindahl; A Hartmann; R Horneland; H Holdaas; A V Reisæter; K Midtvedt; T Leivestad; O Oyen; T Jenssen Journal: Diabetologia Date: 2013-04-03 Impact factor: 10.122
Authors: E B Finger; D M Radosevich; T B Dunn; S Chinnakotla; D E R Sutherland; A J Matas; T L Pruett; R Kandaswamy Journal: Am J Transplant Date: 2013-05-24 Impact factor: 8.086