Incidence of Major Adverse Cardiovascular Events and Cardiac Mortality in High-Risk Kidney-Only and Simultaneous Pancreas−Kidney Transplant Recipients

Lim, Wai H.; Kim, S. Joseph; Knoll, Greg; Shah, Baiju R.; Naylor, Kyla L.; McArthur, Eric; Luo, Bin; Dixon, Stephanie N.; Hawley, Carmel; Ooi, Esther M.M.; Viecelli, Andrea K.; Wong, Germaine

doi:10.1016/j.ekir.2021.02.019

Cited by 3 publications

(3 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lehman et al 16 reported a 10-year mortality of 11.5% and 34.6% in a cohort of 94 SPK/PAK and 38 simultaneous islet-kidney (SIK)/IAK recipients, respectively. Our results following PTx approximate Lehman et al, but also recent reports by Lim et al 17 and the Australia and New Zealand Islet and Pancreas Transplant Registry. 18 Conversely, our findings differ from those reported by the International Pancreas Transplant Registry (10-year mortality rate of 23.9% for SPK and ~30% for PAK).…”

Section: Discussionsupporting

confidence: 92%

“…Length of stay for transplantation was longer for patients in the PTx group, even after accounting for the cumulative length of stay for all islet infusions (6.6 [IQR 5-9] days for ITx vs. [15][16][17][18][19][20][21][22][23][24][25] days for PTx, P = 1.4 × 10 −41 , Table 2). Costs were higher in the ITx cohort, partly due to repeated islet isolations.…”

Section: Length Of Stay and Cost Analysismentioning

confidence: 99%

See 1 more Smart Citation

Pancreas and Islet Transplantation: Comparative Outcome Analysis of a Single-centre Cohort Over 20-years

et al. 2022

View full text Add to dashboard Cite

Objective: To provide the largest single-center analysis of islet (ITx) and pancreas (PTx) transplantation. Summary Background Data: Studies describing long-term outcomes with ITx and PTx are scarce. Methods: We included adults undergoing ITx (n = 266) and PTx (n = 146) at the University of Alberta from January 1999 to October 2019. Outcomes include patient and graft survival, insulin independence, glycemic control, procedure-related complications, and hospital readmissions. Data are presented as medians (interquartile ranges, IQR) and absolute numbers (percentages, %) and compared using Mann-Whitney and χ 2 tests. Kaplan-Meier estimates, Cox proportional hazard models and mixed main effects models were implemented. Results: Crude mortality was 9.4% and 14.4% after ITx and PTx, respectively (P = 0.141). Sex-adjusted and age-adjusted hazard-ratio for mortality was 2.08 (95% CI, 1.04-4.17, P = 0.038) for PTx versus ITx. Insulin independence occurred in 78.6% and 92.5% in ITx and PTx recipients, respectively (P = 0.0003), while the total duration of insulin independence was 2.1 (IQR 0.8-4.6) and 6.7 (IQR 2.9-12.4) year for ITx and PTx, respectively (P = 2.2×10 -22 ). Graft failure ensued in 34.2% and 19.9% after ITx and PTx, respectively (P = 0.002). Glycemic control improved for up to 20-years post-transplant, particularly for PTx recipients (group, P = 7.4×10 -7 , time, P = 4.8×10 -6 , group*time, P = 1.2×10 -7 ). Procedure-related complications and hospital readmissions were higher after PTx (P = 2.5×10 -32 and P = 6.4×10 -112 , respectively). Conclusions: PTx shows higher sex-adjusted and age-adjusted mortality, procedure-related complications and readmissions compared with ITx. Conversely, insulin independence, graft survival and glycemic control are better with PTx. This study provides data to balance risks and benefits with ITx and PTx, which could improve shared decision-making.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Length Of Stay and Cost Analysismentioning

confidence: 99%

Pancreas and Islet Transplantation: Comparative Outcome Analysis of a Single-centre Cohort Over 20-years

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Two studies showed that patients with kidney failure and diabetes experienced a significant survival disadvantage compared to patients without diabetes [ 5 , 6 ]. Similar survival disadvantage has also been shown in patients who have developed PTDM after kidney transplantation [ 11–13 ]. However, there is little data about the association between diabetes status and outcome on dialysis following kidney allograft loss.…”

Section: Discussionsupporting

confidence: 71%

Association between diabetic status and risk of all-cause and cause-specific mortality on dialysis following first kidney allograft loss

Samarasinghe,

Wong,

Teixeira-Pinto

et al. 2024

Clinical Kidney Journal

Self Cite

View full text Add to dashboard Cite

Background Diabetes mellitus (DM) is associated with a greater risk of mortality in kidney transplants patients, primarily driven by a greater risk of cardiovascular disease (CVD)-related mortality. However, the associations between diabetes status at time of first allograft loss and mortality on dialysis remain unknown. Methods All patients with failed first kidney allografts transplanted in Australia and New Zealand between 2000–2020 were included. The associations between diabetes status at first allograft loss, all-cause and cause-specific mortality were examined using competing risk analyses, separating patients with diabetes into those with pre-transplant DM or post-transplant diabetes mellitus (PTDM). Results Of 3782 patients with a median (IQR) follow-up duration of 2.7 (1.1–5.4) years, 539 (14%) and 390 (10%) patients had pre-transplant DM or developed PTDM, respectively. In the follow-up period, 1336 (35%) patients died, with 424 (32%), 264 (20%) and 199 (15%) deaths attributed to CVD, dialysis withdrawal and infection, respectively. Compared to patients without DM, the adjusted subdistribution HRs (95%CI) for pre-transplant DM and PTDM for all-cause mortality on dialysis were 1.47 (1.17–1.84) and 1.47 (1.23–1.76), respectively; for CVD-related mortality were 0.81 (0.51–1.29) and 1.02 (0.70–1.47), respectively; for infection-related mortality were 1.84 (1.02–3.35) and 2.70 (1.73–4.20), respectively; and for dialysis withdrawal- related mortality were 1.71 (1.05–2.77) and 1.51 (1.02–2.22), respectively. Conclusions Patients with diabetes at the time of kidney allograft loss have a significant survival disadvantage, with the excess mortality risk attributed to infection and dialysis withdrawal.

show abstract

A population cohort analysis of English transplant centers indicates major adverse cardiovascular events after kidney transplantation

Anderson¹,

Qasim²,

Evison³

et al. 2022

Kidney International

View full text Add to dashboard Cite

Incidence of Major Adverse Cardiovascular Events and Cardiac Mortality in High-Risk Kidney-Only and Simultaneous Pancreas−Kidney Transplant Recipients

Cited by 3 publications

References 7 publications

Pancreas and Islet Transplantation: Comparative Outcome Analysis of a Single-centre Cohort Over 20-years

Pancreas and Islet Transplantation: Comparative Outcome Analysis of a Single-centre Cohort Over 20-years

Association between diabetic status and risk of all-cause and cause-specific mortality on dialysis following first kidney allograft loss

A population cohort analysis of English transplant centers indicates major adverse cardiovascular events after kidney transplantation

Contact Info

Product

Resources

About