Effect of Race on Outcome After Kidney and Kidney-Pancreas Transplantation in Type 1 Diabetic Patients
| Autor: | V. Douzdjian, P. R. Rajagopalan, Prabakar K. Baliga, Kristene Gugliuzza, S Shanmuga Bhaskar |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Black People Pancreas transplantation Gastroenterology White People Risk Factors Diabetes mellitus Internal medicine Internal Medicine medicine Humans Survival rate Kidney transplantation Retrospective Studies Advanced and Specialized Nursing Kidney business.industry Proportional hazards model Graft Survival Retrospective cohort study medicine.disease Kidney Transplantation Tissue Donors Surgery Survival Rate Transplantation Diabetes Mellitus Type 1 Treatment Outcome medicine.anatomical_structure Female Pancreas Transplantation business Follow-Up Studies |
| Zdroj: | Diabetes Care. 20:1310-1314 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/diacare.20.8.1310 |
| Popis: | OBJECTIVE The racial impact on graft outcome is not well defined in diabetic recipients. The purpose of this study is to analyze our experience with kidney-alone (KA) and kidney-pancreas (KP) transplantation in type 1 diabetic recipients and evaluate the impact of racial disparity on outcome. RESEARCH DESIGN AND METHODS The records of 217 kidney transplants (118 KA, 99 KP) performed on type 1 diabetic patients between 1985 and 1995 at the Medical University of South Carolina and the University of Texas Medical Branch were reviewed. RESULTS A total of 53 (31%) white patients and 15 (33%) black patients experienced at least one episode of biopsy-proven acute rejection of the renal graft (NS). Patient survival at 1, 2, and 5 years was similar in white (92, 87, 69%) and black (91, 91, 69%) patients (NS). Kidney graft survival at 1, 2, and 5 years in the KA group was 72, 62, and 42% in blacks, compared with 79, 76, and 53% in whites (NS). Kidney graft survival at 1, 2, and 5 years in the KP group was 92, 92, and 74% in blacks, compared with 83, 77, and 58% in whites (NS). Pancreas graft survival at 1, 2, and 5 years was 81, 81, and 81% in blacks, compared with 81, 75, and 62% in whites (NS). Cox regression analysis revealed that donor age ≥ 40 years increased the risk of renal graft failure 6.2-fold (P = 0.0001), whereas the addition of a pancreas transplant to a kidney and a living-related transplant decreased the risk of failure of the kidney graft 0.2 (P = 0.005) and 0.1 times (P = 0.005). CONCLUSIONS Our results suggest that when compared with whites, there may be a trend toward an improved kidney and pancreas graft outcome in blacks undergoing KP transplants. These findings suggest that diabetes may override the risk factors that account for the pronounced disparity in outcome observed between nondiabetic white and black recipients. |
| Databáze: | OpenAIRE |
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