Pancreas Transplantation: Does Age Increase Morbidity?

Afaneh, Cheguevara; Rich, Barrie S.; Aull, Meredith J.; Hartono, Choli; Leeser, David B.; Kapur, Sandip

doi:10.1155/2011/596801

Cited by 22 publications

(27 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While there were no factors identified to predict risk of MI or kidney graft loss, donor age was identified as a potentially useful risk factor for pancreas graft loss. Donor age has been established in many single‐centre and national database analyses to be associated with poor pancreas graft survival and forms the most significant predictor in the Pancreas Donor Risk Index .…”

Section: Discussionmentioning

confidence: 99%

An analysis of the association between older recipient age and outcomes after whole‐organ pancreas transplantation – a single‐centre, retrospective study

Mittal

Smilevska²,

Franklin

et al. 2020

Transpl Int

View full text Add to dashboard Cite

Summary Older people are increasingly being referred for consideration for pancreas transplantation (PT). We investigated the outcomes after PT in our older recipient cohort. A prospectively maintained database was interrogated. The cohort was analysed for associations between outcome and older recipient age. A total of 444 transplants were performed in patients aged 23–54 years and 83 transplants in patients aged 55–67 years. There was no difference in death‐censored pancreas or kidney graft survival between the groups. Patient death was associated with older recipient age (HR 1.63 per 10‐year increase). In multivariate Cox regression, risk of mortality was also associated with post‐transplant myocardial infarction (HR 7.25, P = 0.006), pancreas failure (HR 1.91, P = 0.003) and kidney failure (HR 3.55, P < 0.001). About 40% of recipients who died in the first year post‐transplant suffered early graft loss. Those alive at a year post‐transplant had inferior survival if they had lost their kidney graft (P < 0.001). Mortality is higher in older patients and is strongly associated with pancreas and kidney graft failure. This suggests that pancreas transplantation is feasible in older recipients, and careful selection of donor organs is important to optimize survival.

show abstract

Section: Discussionmentioning

confidence: 99%

An analysis of the association between older recipient age and outcomes after whole‐organ pancreas transplantation – a single‐centre, retrospective study

Mittal

Smilevska²,

Franklin

et al. 2020

Transpl Int

View full text Add to dashboard Cite

show abstract

“…Recipient age may also be a risk factor for poor outcomes after SPKT and contribute to pancreas or kidney failure. In many studies, recipient age has not been found to be a risk factor for relaparotomy [8,28], technical complications [19,28] or length of stay [28], although two studies found higher rates of bleeding in patients 50 years of age or older [29,30]. Whereas the aforementioned studies have evaluated donor and recipient risk factors for graft loss separately, ours is the first report to stratify outcomes by age-matched groups and to test for an interaction between donor and recipient age following SPKT.…”

Section: Discussionmentioning

confidence: 88%

Outcomes and survival analysis of old-to-old simultaneous pancreas and kidney transplantation

et al. 2013

View full text Add to dashboard Cite

SummaryOutcomes of old-donor simultaneous pancreas-kidney transplantation (SPKT) have not been thoroughly studied. Scientific Registry of Transplant Recipients data reported for SPKT candidates receiving dialysis wait-listed between 1993 and 2008 (n = 7937) were analyzed for outcomes among those who remained listed (n = 3301) and of SPKT recipients (n = 4636) using multivariable time-dependent regression models. Recipients were stratified by donor/recipient age (cutoff 40 years) into: young-to-young (n = 2099), young-to-old (n = 1873), old-to-young (n = 293), and old-to-old (n = 371). The overall mortality was 12%, 14%, 20%, and 24%, respectively, for those transplanted, and 50% for those remaining on the waiting list. On multivariable analysis, old-donor SPKT was associated with significantly higher overall risks of patient death, death-censored pancreas, and kidney graft failure in both young (73%, 53%, and 63% increased risk, respectively) and old (91%, 124%, and 85% increased risk, respectively) recipients. The adjusted relative mortality risk was similar for recipients of olddonor SPKT compared with wait-listed patients including those who subsequently received young-donor transplants (aHR 0.95; 95% CI 0.78, 1.12) except for candidates in OPOs with waiting times ≥604 days (aHR 0.65, 95% CI 0.45-0.94). Old-donor SPKT results in significantly worse graft survival and patient mortality without any waiting-time benefit as compared to young-donor SPKT, except for candidates with expected long waiting times.

show abstract

“…Other studies have shown a lower patient survival for older patients (45 years or older) undergoing pancreas transplantation [29,30]. The authors concluded that older patients with type 1 diabetes are feasible suitable candidates for pancreas transplantation [32]. The rejection rate is lower in older than in younger recipients [29], but those older than 50 years have an increased rate of postoperative complications that should be taken into account when the benefits and risks are assessed [31].…”

Section: Agementioning

confidence: 98%