Risk Factors of Pancreatic Graft Loss and Death of Receptor After Simultaneous Pancreas/Kidney Transplantation

Sousa, Marcelo Gonçalves; Linhares, Marcelo Moura; Netto, Alcides Augusto Salzedas; Gonzalez, A.M.; Rangel, Érika B.; Sá, João Roberto de; Araújo, Stella; Melaragno, Cláudio S.; Lopes-Filho, Gaspar Jesus; Medina-Pestana, J.O.

doi:10.1016/j.transproceed.2014.05.048

Cited by 17 publications

(11 citation statements)

References 24 publications

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“…It is more likely that this study reflects findings in other allograft subtypes of an otherwise distinct protective effect of MPA, possibly due to reduction in allograft vasculopathy. This is further supported by our statistical analyses in which we identified other literature validated risk factors for pancreas graft loss, including donor age . Future in vitro and in vivo studies are needed to specifically evaluate this effect in the pancreas allograft.…”

Section: Discussionsupporting

confidence: 69%

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Impact of intensive dosing of mycophenolate on pancreas allograft survival

Descourouez

Jorgenson

Menninga

et al. 2018

Clinical Transplantation

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Section: Discussionsupporting

confidence: 69%

“…This is further supported by our statistical analyses in which we identified other literature validated risk factors for pancreas graft loss, including donor age. 17 Future in vitro and in vivo studies are needed to specifically evaluate this effect in the pancreas allograft.…”

Section: Discussionmentioning

confidence: 99%

Impact of intensive dosing of mycophenolate on pancreas allograft survival

Descourouez

Jorgenson

Menninga

et al. 2018

Clinical Transplantation

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“…The purpose of using the landmark analysis technique was to estimate the survival probabilities with no time-to-event bias [ 20 , 30 ]. Based on previous studies [ 16 , 17 , 31 ] and our own clinical observations that the first 3 months post-transplant represent a vulnerable period of pancreatic graft loss, the landmark was set at 3 months a priori. In fact, technical failures are the most common cause of pancreas graft loss and predominantly occur in the first 3 months after SPKT [ 16 , 17 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Early Pancreatic Graft Loss on Outcome after Simultaneous Pancreas–Kidney Transplantation (SPKT)—A Landmark Analysis

Lehner

Öllinger

Globke

et al. 2021

JCM

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(1) Background: Simultaneous pancreas–kidney transplantation (SPKT) is a standard therapeutic option for patients with diabetes mellitus type I and kidney failure. Early pancreas allograft failure is a complication potentially associated with worse outcomes. (2) Methods: We performed a landmark analysis to assess the impact of early pancreas graft loss within 3 months on mortality and kidney graft survival over 10 years. This retrospective single-center study included 114 adult patients who underwent an SPKT between 2005 and 2018. (3) Results: Pancreas graft survival rate was 85.1% at 3 months. The main causes of early pancreas graft loss were thrombosis (6.1%), necrosis (2.6%), and pancreatitis (2.6%). Early pancreas graft loss was not associated with reduced patient survival (p = 0.168) or major adverse cerebral or cardiovascular events over 10 years (p = 0.741) compared to patients with functioning pancreas, after 3 months. Moreover, kidney graft function (p = 0.494) and survival (p = 0.461) were not significantly influenced by early pancreas graft loss. (4) Conclusion: In this study, using the landmark analysis technique, early pancreas graft loss within 3 months did not significantly impact patient or kidney graft survival over 10 years.

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“…An earlier study from the Amaral group identified independent risk factors for pancreatic graft loss: recipient BMI, induction therapy, donor age, iliac venous drainage, and transplantation of the pancreas as the first graft. A risk stratification model was constructed and ROC curves were calculated, yet the model included few donor-dependent and non-modifiable variables; therefore, its applicability was limited [ 12 ]. We did not analyze recipient-dependent factors and tailored our study to allow deciding whether to accept a potential pancreas donor.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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BackgroundPre-procurement pancreas suitability score (P-PASS) and pancreas donor risk (PDRI) index are scoring systems believed to predict suitability of pancreatic grafts. Most European countries and the United States apply PDRI, while Poltransplant keeps using P-PASS: more than 16 points raises a red flag for graft use. Recent data discourage use of PDRI to predict pancreas graft survival. The aim of the present study was to assess PDRI and P-PASS as predictors of transplanted pancreas survival in a Polish population.Material/MethodsFrom February 1998 to September 2015, 407 pancreas transplantations were performed in Poland: 370 (90.9%) simultaneous pancreas-kidney transplantation and 37 (9.1%) pancreas transplantation alone or pancreas after kidney. The endpoint was death-uncensored 12-month graft survival with satisfactory glycemic control without insulin.ResultsAverage P-PASS was 15.9±2.66 and PDRI was 0.96±0.37. Recipients who survived 12 months with good graft function had an average P-PASS score of 15.7 and PDRI of 0.95. Recipients with death-uncensored graft loss had a mean P-PASS of 16.4 and PDRI of 0.99. Univariate analysis revealed donor age, body mass index (BMI), and P-PASS to be significant risk factors for 1-year pancreas graft survival.ConclusionsP-PASS, but not PDRI, is a reliable tool to predict pancreas graft survival in the Polish population.

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Risk Factors of Pancreatic Graft Loss and Death of Receptor After Simultaneous Pancreas/Kidney Transplantation

Cited by 17 publications

References 24 publications

Impact of intensive dosing of mycophenolate on pancreas allograft survival

Impact of intensive dosing of mycophenolate on pancreas allograft survival

Impact of Early Pancreatic Graft Loss on Outcome after Simultaneous Pancreas–Kidney Transplantation (SPKT)—A Landmark Analysis

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

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