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Ten years of simultaneous pancreas-kidney transplantation: a retrospective single-center analysis of prospectively obtained data.
- Source :
-
Transplantation proceedings [Transplant Proc] 2011 Nov; Vol. 43 (9), pp. 3267-9. - Publication Year :
- 2011
-
Abstract
- Introduction: Simultaneous pancreas-kidney transplantation (SPK) is a standardized and life-saving procedure for a patient suffering from both insulin-dependent diabetes mellitus type 1 (IDDM 1) and end-stage diabetic nephropathy. To expand the donor pool and to determine the influence of the preprocurement pancreas suitability scoring system (P-PASS) on pancreas graft survival we retrospectively analyzed our data on SPK.<br />Patients and Methods: From 1999 to 2010 we performed 55 SPKs, using systemic-enteric drainage as surgical approach. The immunosuppressive therapy was induced with basiliximab; maintenance therapy was based on tacrolimus, mycophenolate mofetil, and steroids. Data were prospectively obtained, analyzed, and correlated to the P-PASS.<br />Results: The overall 10-year patient survival rate was 78% with a 10-year pancreas survival rate of 53%. Three patients needed retransplantation of SPK and 6 patients needed singular pancreas retransplantation. Seventeen patients showed acute rejection episodes and 14 patients suffered from cytomegalovirus (CMV) infections. We compared 43 patients receiving organs from an "ideal" donor (P-PASS <17) with 12 patients receiving grafts from "marginal" donors (P-PASS ≥17). Neither P-PASS nor donor age demonstrated significant influence on pancreas graft survival. However, the body mass index (BMI) of the donor showed a negative tendency (P = .059).<br />Conclusion: The P-PASS showed no significant prediction of pancreas graft survival. In view of our data, expansion of the German donor pool is possible. A multicenter study of SPK using "marginal" pancreas grafts is mandatory to define a realistic "cut-off" value for P-PASS.<br /> (Copyright © 2011 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Body Mass Index
Cell Survival
Female
Graft Rejection
Graft Survival
Humans
Immunosuppressive Agents therapeutic use
Male
Middle Aged
Prospective Studies
Retrospective Studies
Treatment Outcome
Diabetes Mellitus, Type 1 therapy
Diabetic Nephropathies therapy
Kidney Transplantation methods
Pancreas Transplantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2623
- Volume :
- 43
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 22099773
- Full Text :
- https://doi.org/10.1016/j.transproceed.2011.09.099