Long‐term Lower Extremity and Cardiovascular Complications after Simultaneous Pancreas‐Kidney Transplant
Autor: | Dominic Amara, Amy Shui, Anna Mello, Peter G. Stock, Joel L. Ramirez, Hillary J. Braun, Joseph Lin, Thomas A. Sorrentino, Jade S. Hiramoto, Iris H. Liu |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Disease 030230 surgery Kidney 03 medical and health sciences 0302 clinical medicine medicine Humans Risk factor Pancreas Retrospective Studies Transplantation Type 1 diabetes Vascular disease business.industry Incidence (epidemiology) Graft Survival Podiatry medicine.disease Kidney Transplantation Surgery Diabetes Mellitus Type 1 Lower Extremity Amputation 030211 gastroenterology & hepatology Pancreas Transplantation business |
Zdroj: | Clinical Transplantation. 35 |
ISSN: | 1399-0012 0902-0063 |
Popis: | Lower extremity (LE) vascular disease and adverse cardiovascular events (ACEs) cause significant long-term morbidity after simultaneous pancreas-kidney (SPK) transplantation. This study's purpose was to describe the incidence of, and risk factors associated with, LE vascular complications and related ACEs following SPK. All SPKs performed at the authors' institution from 2000 to 2019 were retrospectively analyzed. The primary outcome was any LE vascular event, defined as LE endovascular intervention, open surgery, amputation, or invasive podiatry intervention. Secondary outcomes included post-SPK ACE. A total of 363 patients were included, of whom 54 (14.9%) required at least one LE vascular intervention following SPK. Only 3 patients received pre-SPK ankle brachial indices (ABIs). A history of peripheral artery disease (PAD) (HR 2.95, CI 1.4-6.2) was a risk factor for post-SPK LE vascular intervention even after adjustment for other factors. Fifty-nine (16.3%) patients experienced an ACE in follow-up. Requiring a LE intervention post-SPK was associated with a subsequent ACE (HR 2.3, CI 1.2-4.5). LE vascular and cardiovascular complications continue to be significant sources of morbidity for SPK patients, especially for patients with preexisting PAD. The highest risk patients may benefit from more intensive pre- and post-SPK workup with ABIs and follow-up with a vascular surgeon. |
Databáze: | OpenAIRE |
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