TY - JOUR
T1 - Survival After Simultaneous Pancreas‐Kidney Transplantation in Type 1 Diabetes
T2 - The Critical Role of Early Pancreas Allograft Function
AU - Ji, Mengmeng
AU - Wang, Mei
AU - Hu, Wenjun
AU - Ibrahim, Mohamed
AU - Lentine, Krista
AU - Merzkani, Massini
AU - Murad, Haris
AU - Al-Hosni, Yazen
AU - Parsons, Ronald
AU - Wellen, Jason
AU - Chang, Su Hsin
AU - Alhamad, Tarek
N1 - Publisher Copyright:
Copyright © 2022 Ji, Wang, Hu, Ibrahim, Lentine, Merzkani, Murad, Al-Hosni, Parsons, Wellen, Chang and Alhamad.
PY - 2022/9/12
Y1 - 2022/9/12
N2 - Simultaneous pancreas-kidney transplantation (SPK) carries about a 7%–22% risk of technical failure, but the impact of early pancreas allograft loss on subsequent kidney graft and patient survival is not well-defined. We examined national transplant registry data for type 1 diabetic patients who received SPK between 2000 and 2021. Associations of transplant type (i.e., SPK, deceased‐donor kidney transplant [DDKA], living‐donor kidney transplant [LDKA]) with kidney graft failure and patient survival were estimated by multivariable inverse probability of treatment-weighted accelerated failure-time models. Compared to SPK recipients with a functioning pancreas graft 3 months posttransplant (SPK,P+), LDKA had 18% (Time Ratio [TR] 0.82, 95%CI: 0.70–0.95) less graft survival time and 18% (TR 0.82, 95%CI: 0.68–0.97) less patient survival time, DDKA had 23% (TR 0.77, 95%CI: 0.68–0.87) less graft survival time and 29% (TR 0.71, 95%CI: 0.62–0.81) less patient survival time, and SPK with early pancreas graft loss had 34% (TR 0.66, 95%CI: 0.56–0.78) less graft survival time and 34% (TR 0.66, 95%CI: 0.55–0.79) less patient survival time. In conclusion, SPK,P+ recipients have better kidney allograft and patient survival compared with LDKA and DDKA. Early pancreas graft failure results in inferior kidney and patient survival time compared to kidney transplant alone.
AB - Simultaneous pancreas-kidney transplantation (SPK) carries about a 7%–22% risk of technical failure, but the impact of early pancreas allograft loss on subsequent kidney graft and patient survival is not well-defined. We examined national transplant registry data for type 1 diabetic patients who received SPK between 2000 and 2021. Associations of transplant type (i.e., SPK, deceased‐donor kidney transplant [DDKA], living‐donor kidney transplant [LDKA]) with kidney graft failure and patient survival were estimated by multivariable inverse probability of treatment-weighted accelerated failure-time models. Compared to SPK recipients with a functioning pancreas graft 3 months posttransplant (SPK,P+), LDKA had 18% (Time Ratio [TR] 0.82, 95%CI: 0.70–0.95) less graft survival time and 18% (TR 0.82, 95%CI: 0.68–0.97) less patient survival time, DDKA had 23% (TR 0.77, 95%CI: 0.68–0.87) less graft survival time and 29% (TR 0.71, 95%CI: 0.62–0.81) less patient survival time, and SPK with early pancreas graft loss had 34% (TR 0.66, 95%CI: 0.56–0.78) less graft survival time and 34% (TR 0.66, 95%CI: 0.55–0.79) less patient survival time. In conclusion, SPK,P+ recipients have better kidney allograft and patient survival compared with LDKA and DDKA. Early pancreas graft failure results in inferior kidney and patient survival time compared to kidney transplant alone.
KW - allograft failure
KW - allograft survival
KW - kidney transplant
KW - simultaneous pancreas-kidney transplantation
KW - type 1 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=85138754370&partnerID=8YFLogxK
U2 - 10.3389/ti.2022.10618
DO - 10.3389/ti.2022.10618
M3 - Article
C2 - 36171743
AN - SCOPUS:85138754370
SN - 0934-0874
VL - 35
JO - Transplant International
JF - Transplant International
M1 - 10618
ER -