Three-month pancreas graft function significantly influences survival following simultaneous pancreas-kidney transplantation in type 2 diabetes patients
| Autor: | Veronica Hicks, Mark A. Schnitzler, Jason R. Wellen, Alexander C. Wiseman, Mei Wang, Kricia Ruano, Daniel C. Brennan, Krista L. Lentine, Ryan Kunjal, Su-Hsin Chang, Tarek Alhamad |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Urology Type 2 diabetes 030230 surgery 03 medical and health sciences 0302 clinical medicine medicine Immunology and Allergy Humans Pharmacology (medical) Pancreas Transplantation Kidney business.industry Hazard ratio Simultaneous pancreas kidney transplantation Graft Survival Type 2 Diabetes Mellitus medicine.disease Kidney Transplantation medicine.anatomical_structure Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 Pancreas Transplantation business Kidney disease |
| Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant SurgeonsREFERENCES. 20(3) |
| ISSN: | 1600-6143 |
| Popis: | Successful simultaneous pancreas-kidney transplantation (SPK) improves quality-of-life and prolongs kidney allograft and patient survival in type-1 diabetic (T1DM) patients. However, the use of SPK in type-2 diabetic (T2DM) patients remains limited. We examined a national transplant registry for 35 849 T2DM kidney disease patients who received transplant between 2000 and 2016 and survived the first 3 months with a functioning kidney, and categorized as: deceased-donor kidney transplant alone (DD-KA, 68%), living-donor kidney transplant alone (LD-KA, 30%), or SPK (2%). Among SPK recipients, 6% had pancreas allograft failure within 3 months (SPK,P-) and 94% had a functional pancreas (SPK,P+). Associations of transplant type with kidney allograft failure and death (multivariable-adjusted hazard ratio, 95%LCL aHR95%UCL ), over follow-up through December 2018, were quantified by multivariable inverse probability of treatment weighted survival analyses. SPK recipients had better kidney graft and patient survival than LD-KA or DD-KA recipients. Compared to SPK,P+, DD-KA, or LD-KA recipients had significantly higher risk of kidney allograft failure (DD-KA: aHR 1.53 2.203.17 ; LD-KA: aHR 1.29 1.872.71 ) and death (DD-KA: aHR 2.12 3.255.00 ; LD-KA: aHR 1.54 2.353.59 ). SPK,P- recipients had significantly higher risk of death (aHR 1.68 3.306.50 ). Similar to T1DM, T2DM patients with SPK have a survival benefit compared to those with kidney transplant alone, but this benefit depends upon successful early pancreas function. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text