Factors affecting diabetic patient's long-term quality of life after simultaneous pancreas-kidney transplantation: a single-center analysis.

Autor: López-Sánchez J; Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.; Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain., Esteban C; Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.; Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain., Iglesias MJ; Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.; Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain., González LM; Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.; Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain., Quiñones JE; Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.; Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain., González-Muñoz JI; Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.; Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain., Tabernero G; Department of Nephrology, Hospital Universitario de Salamanca, Salamanca, Spain., Iglesias RA; Department of Endocrinology, Hospital Universitario de Salamanca, Salamanca, Spain., Fraile P; Department of Nephrology, Hospital Universitario de Salamanca, Salamanca, Spain., Muñoz-González JI; Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain.; Cancer Research Center (IBMCC, USAL-CSIC), Department of Medicine and Cytometry Service (NUCLEUS), Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Universidad de Salamanca, Salamanca, Spain., Muñoz-Bellvís L; Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain. luismb@usal.es.; Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain. luismb@usal.es.; Department of Surgery, Hospital Universitario de Salamanca, Paseo San Vicente, 88-132, 37007, Salamanca, Spain. luismb@usal.es.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2021 May; Vol. 406 (3), pp. 873-882. Date of Electronic Publication: 2021 Jan 08.
DOI: 10.1007/s00423-020-02059-8
Abstrakt: Purpose: Pancreas transplantation (PT) is one of the few ways to restore euglycemia within diabetic patients; however, the high morbidity caused by surgical complications and the need for immunosuppressive therapy has raised controversy about PT improving the health-related quality-of-life (HRQoL). The aim of this study is to assess the long-term (≥ 5 years after PT) HRQoL and to identify the factors affecting it.
Methods: A single-center, cross-sectional study of 49 sequential PT was performed. All patients conducted a telephone interview to fulfill the modification of Medical Outcome Health Survey Short Form questionnaire (SF-36v2) and were compared to similar post-PT studies from the literature.
Results: Patients with a history of replacement renal therapy (RRT) or neuropathy undergoing a PT were associated to a worse bodily pain (P = 0.03) and physical function (P = 0.04), respectively, whereas those with retinopathy showed an improved Role Emotional (P = 0.04). Multivariate analysis revealed the presence of RRT as the only independent prognostic factor for a worse bodily pain [relative risk = 3.9; 95% confidence interval (1.1-14.6)], (P = 0.04). Furthermore, nearly all PT recipients (91.8%) claimed an overall better health than prior to PT.
Conclusion: Our study confirms that PT recipients' HRQoL improves after PT, showing similar HRQoL scores across different populations and suggests that patients in predialysis could benefit from an improved HRQoL if transplanted on the early stages of the disease.
Databáze: MEDLINE
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