Literature DB >> 26274754

A prospective cohort study of risk prediction in simultaneous pancreas and kidney transplantation.

H A Khambalia1, Z Moinuddin1, A M Summers1, A Tavakoli1, R Pararajasingam1, T Campbell1, R Dhanda1, B Forgacs1, T Augustine1, D van Dellen1.   

Abstract

INTRODUCTION: Current risk prediction scoring systems in pancreas transplantation are limited to organ factors and are specific to predicting graft outcome. They do not consider recipient factors or inform regarding recipient morbidity. The aim of this study was to assess the utility of commonly used general surgical risk prediction models (P-POSSUM [Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity], MODS [multiple organ dysfunction score], Charlson co-morbidity index, revised cardiac risk index, ASA [American Society of Anesthesiologists] grade and Waterlow score), and to correlate them with total length of hospital stay (LOS) and critical care unit (CCU) LOS, important surrogate markers of patient outcome.
METHODS: All risk prediction scores were calculated prospectively for all simultaneous pancreas and kidney (SPK) transplant recipients from November 2011 to October 2013, and correlated with outcome measures.
RESULTS: Overall, 57 SPK transplant recipients were analysed. The mean age was 42.0 years (standard deviation [SD]: 7.60 years), 27 (52%) were male and the mean body mass index was 25.43kg/m(2) (SD: 3.11kg/m(2)). The mean pancreas and kidney cold ischaemic times were 703 minutes (SD: 182 minutes) and 850 minutes (SD: 192 minutes) respectively. The median total LOS and mean CCU LOS was 17 days (range: 8-79 days) and 7 days (SD: 4.04 days) respectively. When correlated with risk prediction scores, Waterlow score was the only significant predictor of total LOS and CCU LOS (p<0.001 [Spearman's correlation] and p=0.001 [Pearson's correlation] respectively).
CONCLUSIONS: Preoperative risk prediction plays an important part in planning perioperative care. To date, no validated risk prediction scoring system exists for SPK transplantation. This prospective study indicates that Waterlow score identifies high risk individuals and has value in the prediction of outcome following SPK transplantation.

Entities:  

Keywords:  Outcome assessment; Pancreas transplantation; Risk

Mesh:

Year:  2015        PMID: 26274754      PMCID: PMC5126239          DOI: 10.1308/rcsann.2015.0001

Source DB:  PubMed          Journal:  Ann R Coll Surg Engl        ISSN: 0035-8843            Impact factor:   1.891


  29 in total

1.  How to recognize a suitable pancreas donor: a Eurotransplant study of preprocurement factors.

Authors:  M T Vinkers; A O Rahmel; M C Slot; J M Smits; W D Schareck
Journal:  Transplant Proc       Date:  2008-06       Impact factor: 1.066

2.  The ASA Physical Status Classification: inter-observer consistency. American Society of Anesthesiologists.

Authors:  P H K Mak; R C H Campbell; M G Irwin
Journal:  Anaesth Intensive Care       Date:  2002-10       Impact factor: 1.669

Review 3.  Nutritional management of stage 5 chronic kidney disease.

Authors:  Franca Pasticci; Anna Laura Fantuzzi; Marisa Pegoraro; Margaret McCann; Giorgio Bedogni
Journal:  J Ren Care       Date:  2012-03

4.  Determinants of long-term survival after major surgery and the adverse effect of postoperative complications.

Authors:  Shukri F Khuri; William G Henderson; Ralph G DePalma; Cecilia Mosca; Nancy A Healey; Dharam J Kumbhani
Journal:  Ann Surg       Date:  2005-09       Impact factor: 12.969

5.  Incidence of minor and major amputations after pancreas/kidney transplantation.

Authors:  Guido Woeste; Christoph Wullstein; Olaf Pridöhl; Peter Lübke; Rene Schwarz; Kay Kohlhaw; Wolf O Bechstein
Journal:  Transpl Int       Date:  2002-12-10       Impact factor: 3.782

6.  Systematic evaluation of pancreas allograft quality, outcomes and geographic variation in utilization.

Authors:  D A Axelrod; R S Sung; K H Meyer; R A Wolfe; D B Kaufman
Journal:  Am J Transplant       Date:  2010-02-01       Impact factor: 8.086

7.  Mortality assessment for pancreas transplants.

Authors:  Rainer W G Gruessner; David E R Sutherland; Angelika C Gruessner
Journal:  Am J Transplant       Date:  2004-12       Impact factor: 8.086

Review 8.  Complications after pancreas transplantation.

Authors:  Christoph Troppmann
Journal:  Curr Opin Organ Transplant       Date:  2010-02       Impact factor: 2.640

9.  A comparative analysis of nutritional parameters as predictors of outcome in male and female ESRD patients.

Authors:  Peter Stenvinkel; Peter Barany; Sung Hee Chung; Bengt Lindholm; Olof Heimbürger
Journal:  Nephrol Dial Transplant       Date:  2002-07       Impact factor: 5.992

Review 10.  Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome.

Authors:  J C Marshall; D J Cook; N V Christou; G R Bernard; C L Sprung; W J Sibbald
Journal:  Crit Care Med       Date:  1995-10       Impact factor: 7.598

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  5 in total

1.  Waterlow score as a surrogate marker for predicting adverse outcome in acute pancreatitis.

Authors:  K Gillick; H Elbeltagi; S Bhattacharya
Journal:  Ann R Coll Surg Engl       Date:  2016-01       Impact factor: 1.891

Review 2.  The comparative and added prognostic value of biomarkers to the Revised Cardiac Risk Index for preoperative prediction of major adverse cardiac events and all-cause mortality in patients who undergo noncardiac surgery.

Authors:  Lisette M Vernooij; Wilton A van Klei; Karel Gm Moons; Toshihiko Takada; Judith van Waes; Johanna Aag Damen
Journal:  Cochrane Database Syst Rev       Date:  2021-12-21

3.  Waterlow score for risk assessment in surgical patients: a systematic review.

Authors:  S K Nayar; D Li; B Ijaiya; D Lloyd; R Bharathan
Journal:  Ann R Coll Surg Engl       Date:  2021-04-14       Impact factor: 1.951

4.  Usefulness of Pancreas Donor Risk Index and Pre-Procurement Pancreas Allocation Suitability Score: Results of the Polish National Study.

Authors:  Kaja Śmigielska; Paweł Skrzypek; Jarosław Czerwiński; Grzegorz Michalak; Marek Durlik; Tadeusz Grochowiecki; Sławomir Nazarewski; Jacek Szmidt; Jacek Ziaja; Robert Król; Lech Cierpka; Wojciech Lisik; Maciej Kosieradzki
Journal:  Ann Transplant       Date:  2018-05-25       Impact factor: 1.530

5.  Pre-operative Waterlow score and outcomes after kidney transplantation.

Authors:  Anna Brotherton; Felicity Evison; Suzy Gallier; Adnan Sharif
Journal:  BMC Nephrol       Date:  2022-08-04       Impact factor: 2.585

  5 in total

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