Long-term Pancreas Allograft Survival in Simultaneous Pancreas-Kidney Transplantation by Era.
Waki K, Sugawara Y, Kokudo N, Kadowaki T.
Clinical Transplants 2012, Chapter 2
Data collected by UNOS from all approved US transplant programs were analyzed. The analysis was based on data for 22,075 diabetic patients who received a pancreas transplant between January 1995 and December 2011. Simultaneous pancreas-kidney (SPK) transplantation was the major therapeutic option for diabetes patients. SPK had better survival than pancreas transplantation alone (PTA) or pancreas-after-kidney (PAK) transplantation. The 5-year pancreas graft survival rate for SPK, PAK, and PTA was 71.3%, 56.6%, and 53.0%, respectively. When long-term SPK pancreas graft survival was examined by transplant era, there was no survival improvement after 1995. The effect of year of transplant was estimated using Cox proportional hazard models. The 5-year pancreas graft survival rate in the eras 1995-1998, 1999-2002 and 2003-2006 were 69.2%, 69.8%, and 72.4%, respectively. For those whose graft survived over one year, the 5-year graft survival rate in those eras was 83.5%, 83.4%, and 85.2%, respectively. The adjusted hazard ratio for overall graft loss by year of transplant for the grafts that survived more than one year in the eras 1999-2002 and 2003-2006 was 1.08 (95% confidence interval [CI], 0.94-1.24) and 0.95 (95% CI, 0.82-1.11), respectively. The survival rate of long-term pancreas grafts remained almost unchanged over time.