Pancreas Graft Survival in Simultaneous Pancreas-kidney Versus Pancreas-after-kidney and Pancreas Alone Transplantations: A Single Institution Experience

Montiel-Casado, María Custodia; Pérez-Daga, J.A.; Aranda-Narváez, José Manuel; Fernández-Burgos, I; Sánchez-Pérez, Belinda; León-Díaz, F.J.; Cabello-Díaz, Mercedes; Rodríguez-Burgos, D.; Marrero, Domingo Hernández; Santoyo-Santoyo, Julio

doi:10.1016/j.transproceed.2013.10.019

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…One year graft survival rates have also improved, from 23% in the early eras to >80% in 2007 onwards, most likely due to reduced technical complications, including graft thrombosis and reduction in immunologic graft loss. 7,42 In our study also, there was significant decrease in graft failure and thrombosis only during the study period between 43 This is contrary to our analysis, where none of these factors play a significant role except longer preservation time.…”

Section: Discussioncontrasting

confidence: 99%

Impact of pancreas transplantation alone on kidney function: A multicenter clinical cohort study

Kaur,

Mujtahedi,

Fridell

et al. 2023

Clinical Transplantation

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Pancreas transplantation alone (PTA) is a β cell replacement option for selected patients with type 1 diabetes mellitus; concerns have been raised regarding deterioration in kidney function (KF) after PTA. This retrospective multicenter study assessed actual impact of transplantation and immunosuppression on KF in PTA recipients at three Transplant Centers. The primary composite endpoint 10 years after PTA was >50% eGFR decline, eGFR < 30 mL/min/1.73 m2, and/or receiving a kidney transplant (KT). Overall, 822 PTA recipients met eligibility. Median baseline and 10‐year eGFR (mL/min/1.73 m2) were 76.3 (58.1–100.8) and 51.3 (35.3–65.9), respectively. Primary composite endpoint occurred in 98 patients (53.5%) with 45 experiencing a >50% decrease in eGFR by 10 years post‐transplant, 38 eGFR < 30 mL/min/1.73 m2 and 49 requiring KT. KF declined most significantly within 6 months post‐PTA, more often in females and patients with better preserved GFR up to 5 years with 11.6% kidney failure at 10 years. Patient survival and death‐censored graft survival were both 68% at 10 years with overall graft thrombosis rate 8%. KF declined initially after PTA but stabilized with further slow progression. In conclusion, prospective intervention studies are needed to test renal sparing interventions while gathering more granular data.

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Section: Discussioncontrasting

confidence: 99%

Impact of pancreas transplantation alone on kidney function: A multicenter clinical cohort study

Kaur,

Mujtahedi,

Fridell

et al. 2023

Clinical Transplantation

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“…Examples of different definitions of pancreas graft failure based on these functional parameters include the reinstitution of any insulin therapy, C-peptide <0.4 ng/mL, the reinstitution of up to 50% of the total pre-pancreas transplant insulin requirement, or reinstitution of insulin at 0.5 units/kg/d (Table 1). [9][10][11][12][13][14] In addition to variable consideration of functional parameters, the duration of insulin use to distinguish temporary graft dysfunction from permanent graft failure was also controversial. The OPTN Pancreas Transplantation Committee performed a multicenter retrospective study to determine if undetectable C-peptide levels correspond to center-reported graft failures.…”

Section: Defining Pancreas Graft Failurementioning

confidence: 99%

Medical and Surgical Management of the Failed Pancreas Transplant

Casey,

Murakami,

Ong

et al. 2023

Transplantation Direct

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Despite the continued improvements in pancreas transplant outcomes in recent decades, a subset of recipients experience graft failure and can experience substantial morbidity and mortality. Here, we summarize what is known about the failed pancreas allograft and what factors are important for consideration of retransplantation. The current definition of pancreas allograft failure and its challenges for the transplant community are explored. The impacts of a failed pancreas allograft are presented, including patient survival and resultant morbidities. The signs, symptoms, and medical and surgical management of a failed pancreas allograft are described, whereas the options and consequences of immunosuppression withdrawal are reviewed. Medical and surgical factors necessary for successful retransplant candidacy are detailed with emphasis on how well-selected patients may achieve excellent retransplant outcomes. To achieve substantial medical mitigation and even pancreas retransplantation, patients with a failed pancreas allograft warrant special attention to their residual renal, cardiovascular, and pulmonary function. Future studies of the failed pancreas allograft will require improved reporting of graft failure from transplant centers and continued investigation from experienced centers.

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“…Our results found little difference between the two groups, which might have been due to the donor source for the SPK. The organs donated for SPK, which are usually from deceased donors, are more likely to have been exposed to longer ischemia times and other potential injuries compared to the organs of living donor transplants, and SKP have stricter criteria for donors than do kidney and other types of pancreas transplants [19]. Thus, it is possible that the stricter criteria for donors also excluded most injured organs, decreasing the risk for death related to cigarette smoking history.…”

Section: Discussionmentioning

confidence: 99%

Influence of donors’ cigarette smoking on recipients’ postoperative survival and complications after simultaneous pancreas-kidney transplantation

Gu¹,

Zhou²,

Xiang³

et al. 2020

Preprint

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Pancreas Graft Survival in Simultaneous Pancreas-kidney Versus Pancreas-after-kidney and Pancreas Alone Transplantations: A Single Institution Experience

Cited by 8 publications

References 10 publications

Impact of pancreas transplantation alone on kidney function: A multicenter clinical cohort study

Impact of pancreas transplantation alone on kidney function: A multicenter clinical cohort study

Medical and Surgical Management of the Failed Pancreas Transplant

Influence of donors’ cigarette smoking on recipients’ postoperative survival and complications after simultaneous pancreas-kidney transplantation

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