Incremental value of the pancreas allograft to the survival of simultaneous pancreas-kidney transplant recipients

Diabetes Care. 2009 Apr;32(4):600-2. doi: 10.2337/dc08-1718. Epub 2009 Jan 8.

Abstract

Objective: To quantify the incremental survival benefit of the pancreas allograft in simultaneous pancreas-kidney (SPK) transplant recipients.

Research design and methods: Data from the national transplant database from 2000 to 2007 were analyzed. SPK recipients who had functioning allografts to 1-year post transplant (n = 3,304) were compared with those who had failure of the renal (n = 233) or pancreatic (n = 112) graft. The main outcome was a projection of 10 life-years of patient survival beyond the first transplant anniversary.

Results: Recipients with function of both organs accrued 9.4 life-years following transplantation. Projected survival in patients with kidney failure was reduced to 2.5 life-years. Pancreas failure reduced predicted survival to 8 life-years. Renal allograft failure impacts life expectancy significantly (adjusted hazard ratio [aHR] 12.13). However, pancreas allograft failure was also associated with reduced survival (aHR 2.62).

Conclusions: Although the majority of the survival benefit of SPK transplant is due to the renal transplant, pancreas allograft function does contribute to patient survival.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Databases, Factual
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Kidney Transplantation / mortality
  • Kidney Transplantation / physiology*
  • Pancreas Transplantation / mortality
  • Pancreas Transplantation / physiology*
  • Retrospective Studies
  • Survival Analysis
  • Survivors
  • Time Factors
  • Transplantation, Homologous
  • Treatment Failure
  • Young Adult