The impact of donor pancreas extraction time on graft survival and postoperative complications in pancreas transplant recipients
| Autor: | Christian Margreiter, Henri G. D. Leuvenink, Robert A. Pol, Stan Benjamens, Marjolein Leemkuil, Franka Messner, Felix J. Krendl |
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| Přispěvatelé: | Groningen Institute for Organ Transplantation (GIOT), Groningen Kidney Center (GKC), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pancreas procurement
medicine.medical_specialty KIDNEY-TRANSPLANTATION Endocrinology Diabetes and Metabolism medicine.medical_treatment Pancreas graft Pancreas transplantation SURGICAL COMPLICATIONS 03 medical and health sciences Postoperative complications 0302 clinical medicine Donor organ extraction time Diabetes mellitus Cox proportional hazards regression medicine INJURY PRESERVATION Kidney OUTCOMES Hepatology business.industry Incidence (epidemiology) Gastroenterology Graft survival medicine.disease Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis PROCUREMENT 030211 gastroenterology & hepatology Pancreas business |
| Zdroj: | Pancreatology, 21(6), 1191-1198. ELSEVIER SCIENCE BV |
| ISSN: | 1424-3903 |
| Popis: | Background: Simultaneous pancreas kidney transplantation (SPK) is the best therapeutic option for patients with diabetes mellitus type 1 and end-stage renal disease. Recently, donor organ extraction time has been shown to affect kidney and liver graft survival. This study aimed to assess the effect of pancreas donor extraction time on graft survival and postoperative complications.Methods: We retrospectively analyzed all pancreas transplants performed in two Eurotransplant centers. The association of pancreas extraction time with pancreas graft survival was analyzed by a Cox proportional hazards regression analysis after 3 months, 1 and 5 year. Besides, the effect of pancreas extraction time on the incidence of severe postoperative complications was analyzed.Results: A total of 317 pancreas transplants were included in this study. Death-censored pancreas graft survival was 85.7% after one year and 76.7% after five years. Median pancreas donor extraction time was 64 min [IQR: 52-79 min]. After adjustment for potential confounders, death censored graft survival after 30 days (HR 1.01, 95% CI 0.9-1.03 (p = 0.23), 1 year (HR 1.01, 95% CI 0.99-1.03 (p = 0.22) and 5 years (HR 1.00, 95% CI 0.99-1.02 (p = 0.57) was not associated with pancreas donor extraction time. However, extraction time was significantly associated with a higher incidence of Clavien-Dindo >3 complications compared to Clavien-Dindo 1 + 2 complications: OR 1.012, 95% CI 1.00-1.02 (p = 0.039).Conclusions: Our findings suggest that although no effect on graft survival was found, limiting pancreas extraction time can have a significant impact on lowering postoperative complications. |
| Databáze: | OpenAIRE |
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