High terminal creatinine donors should not preclude simultaneous kidney and pancreas transplantation
Autor: | Yorg Azzi, Jeffrey Melvin, Enver Akalin, Maria Ajaimy, Omar Alani, Jay A. Graham, Juan P. Rocca, Alma Rechnitzer, Cindy Pynadath, Julia Torabi, Luz Lirano-Ward |
---|---|
Rok vydání: | 2020 |
Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty medicine.medical_treatment Urology Renal function 030230 surgery Pancreas transplantation urologic and male genital diseases Donor Selection 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Diabetes Mellitus Medicine Humans Kidney transplantation Retrospective Studies Kidney Creatinine urogenital system business.industry Graft Survival Acute kidney injury General Medicine medicine.disease Kidney Transplantation Transplantation medicine.anatomical_structure chemistry Kidney Failure Chronic 030211 gastroenterology & hepatology Surgery Female Pancreas Transplantation business Pancreas Biomarkers Glomerular Filtration Rate |
Zdroj: | American journal of surgery. 221(4) |
ISSN: | 1879-1883 |
Popis: | Background Simultaneous pancreas and kidney transplantation (SPK) in the setting of end-stage renal disease offers unmatched outcomes in insulin dependent diabetic patients. Donor pool expansion through the transplantation of kidneys with acute kidney injury (AKI) is controversial. Methods 59 SPK transplants were classified by presence of donor AKI, defined as donor terminal creatinine ≥ 1.5x the initial creatinine or donor terminal creatinine > 4.0 mg/dL. Endpoints included graft and patient survival, delayed graft function (DGF), serum creatinine, glomerular filtration rate (GFR), Hemoglobin A1c (HbA1c) and acute rejection. Results The donor AKI group (n = 35) had significantly higher rates of DGF (38 v. 9%, p = 0.01). There was no difference in creatinine or GFR at 1, 3, 6 and 12 months. HbA1c was comparable at 3, 6 and 12 months. There was no significant difference in the percentage of patients that required anti-diabetic agents after transplant (14 v. 4%, p = 0.56). Conclusions We observed increased rates of DGF in SPK recipients with donor AKI. However, equivalent outcomes of pancreas and kidney function in both groups were observed. |
Databáze: | OpenAIRE |
Externí odkaz: |