Pancreas After Living Donor Kidney Versus Simultaneous Pancreas-Kidney Transplant: An Analysis of the Organ Procurement Transplant Network/United Network of Organ Sharing Database
One of the alternative options to simultaneous pancreas-kidney transplantation (SPKT) for type I diabetics with renal failure is sequential transplant of a living donor kidney followed by a deceased donor pancreas transplant (pancreas after living donor kidney transplant [PALK]). We retrospectively...
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| Veröffentlicht in: | Transplantation 2010-06, Vol.89 (12), p.1496-1503 |
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| creator | POOMMIPANIT, Neda SANTOS SAMPAIO, Marcelo CHO, Yong YOUNG, Brian SHAH, Tariq PHAM, Phuong-Thu WILKINSON, Alan DANOVITCH, Gabriel BUNNAPRADIST, Suphamai |
| description | One of the alternative options to simultaneous pancreas-kidney transplantation (SPKT) for type I diabetics with renal failure is sequential transplant of a living donor kidney followed by a deceased donor pancreas transplant (pancreas after living donor kidney transplant [PALK]). We retrospectively compared the outcomes of SPKT versus PALK.
Adults (age 18-59 years) with type I diabetes who were waitlisted for kidney-pancreas and received a SPKT or PALK between 2000 and 2007 were studied. We compared patient, kidney graft, and pancreas graft survival. Multivariate analysis was performed, and the results were expressed as hazard ratios (HRs) of graft loss and death of PALK, with SPKT as a reference.
Of 11,966 patients who received a kidney transplant, 807 received a PALK and 5580 received a SPKT. Median time to pancreas from kidney transplant was 336 (25%-75%: 185-602 days) days. Average hospital stay for SPKT recipients was 13.2+/-15 days, whereas for PALK recipients was 5.7+/-4 days and 9.5+/-8 days for kidney and pancreas transplants, respectively. After controlling for confounding factors, patients receiving PALK had better patient survival (HR 0.52; 95% confidence interval [CI] 0.39-0.70) and kidney survival (HR 0.48; 95% CI 0.39-0.60) but worse pancreas survival (HR 1.37; 95% CI 1.16-1.62) compared with SPKT.
Among those who were waitlisted for a kidney-pancreas transplant, 53% received a kidney-pancreas transplant. Of those who received a kidney-pancreas transplant, 87% patients underwent SPKT and 13% underwent PALK. PALK was associated with better kidney graft and patient survival compared with SPKT. We found an inferior pancreas graft survival and longer total transplant hospitalization in PALK. |
| doi_str_mv | 10.1097/TP.0b013e3181dd3587 |
| format | Article |
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Adults (age 18-59 years) with type I diabetes who were waitlisted for kidney-pancreas and received a SPKT or PALK between 2000 and 2007 were studied. We compared patient, kidney graft, and pancreas graft survival. Multivariate analysis was performed, and the results were expressed as hazard ratios (HRs) of graft loss and death of PALK, with SPKT as a reference.
Of 11,966 patients who received a kidney transplant, 807 received a PALK and 5580 received a SPKT. Median time to pancreas from kidney transplant was 336 (25%-75%: 185-602 days) days. Average hospital stay for SPKT recipients was 13.2+/-15 days, whereas for PALK recipients was 5.7+/-4 days and 9.5+/-8 days for kidney and pancreas transplants, respectively. After controlling for confounding factors, patients receiving PALK had better patient survival (HR 0.52; 95% confidence interval [CI] 0.39-0.70) and kidney survival (HR 0.48; 95% CI 0.39-0.60) but worse pancreas survival (HR 1.37; 95% CI 1.16-1.62) compared with SPKT.
Among those who were waitlisted for a kidney-pancreas transplant, 53% received a kidney-pancreas transplant. Of those who received a kidney-pancreas transplant, 87% patients underwent SPKT and 13% underwent PALK. PALK was associated with better kidney graft and patient survival compared with SPKT. We found an inferior pancreas graft survival and longer total transplant hospitalization in PALK.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/TP.0b013e3181dd3587</identifier><identifier>PMID: 20414150</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Clinical death. Palliative care. Organ gift and preservation ; Databases, Factual ; Diabetes Complications ; Diabetes Mellitus, Type 1 - therapy ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Survival ; Humans ; Kidney Transplantation - methods ; Living Donors ; Male ; Medical sciences ; Middle Aged ; Pancreas - physiology ; Pancreas Transplantation - methods ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Tissue and Organ Procurement - methods ; Tissue, organ and graft immunology ; United States</subject><ispartof>Transplantation, 2010-06, Vol.89 (12), p.1496-1503</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-194a6bfdab64292462946feaf23c890bf48686ab900c5c98c88e45316e1507f63</citedby><cites>FETCH-LOGICAL-c411t-194a6bfdab64292462946feaf23c890bf48686ab900c5c98c88e45316e1507f63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27926,27927</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22995127$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20414150$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>POOMMIPANIT, Neda</creatorcontrib><creatorcontrib>SANTOS SAMPAIO, Marcelo</creatorcontrib><creatorcontrib>CHO, Yong</creatorcontrib><creatorcontrib>YOUNG, Brian</creatorcontrib><creatorcontrib>SHAH, Tariq</creatorcontrib><creatorcontrib>PHAM, Phuong-Thu</creatorcontrib><creatorcontrib>WILKINSON, Alan</creatorcontrib><creatorcontrib>DANOVITCH, Gabriel</creatorcontrib><creatorcontrib>BUNNAPRADIST, Suphamai</creatorcontrib><title>Pancreas After Living Donor Kidney Versus Simultaneous Pancreas-Kidney Transplant: An Analysis of the Organ Procurement Transplant Network/United Network of Organ Sharing Database</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>One of the alternative options to simultaneous pancreas-kidney transplantation (SPKT) for type I diabetics with renal failure is sequential transplant of a living donor kidney followed by a deceased donor pancreas transplant (pancreas after living donor kidney transplant [PALK]). We retrospectively compared the outcomes of SPKT versus PALK.
Adults (age 18-59 years) with type I diabetes who were waitlisted for kidney-pancreas and received a SPKT or PALK between 2000 and 2007 were studied. We compared patient, kidney graft, and pancreas graft survival. Multivariate analysis was performed, and the results were expressed as hazard ratios (HRs) of graft loss and death of PALK, with SPKT as a reference.
Of 11,966 patients who received a kidney transplant, 807 received a PALK and 5580 received a SPKT. Median time to pancreas from kidney transplant was 336 (25%-75%: 185-602 days) days. Average hospital stay for SPKT recipients was 13.2+/-15 days, whereas for PALK recipients was 5.7+/-4 days and 9.5+/-8 days for kidney and pancreas transplants, respectively. After controlling for confounding factors, patients receiving PALK had better patient survival (HR 0.52; 95% confidence interval [CI] 0.39-0.70) and kidney survival (HR 0.48; 95% CI 0.39-0.60) but worse pancreas survival (HR 1.37; 95% CI 1.16-1.62) compared with SPKT.
Among those who were waitlisted for a kidney-pancreas transplant, 53% received a kidney-pancreas transplant. Of those who received a kidney-pancreas transplant, 87% patients underwent SPKT and 13% underwent PALK. PALK was associated with better kidney graft and patient survival compared with SPKT. We found an inferior pancreas graft survival and longer total transplant hospitalization in PALK.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Clinical death. Palliative care. Organ gift and preservation</subject><subject>Databases, Factual</subject><subject>Diabetes Complications</subject><subject>Diabetes Mellitus, Type 1 - therapy</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Kidney Transplantation - methods</subject><subject>Living Donors</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pancreas - physiology</subject><subject>Pancreas Transplantation - methods</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Tissue and Organ Procurement - methods</subject><subject>Tissue, organ and graft immunology</subject><subject>United States</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV2L1DAUhoMo7rj6CwTJjXjV3aRJ28S7Yf3EwR3YWW_LaXqyG23TMUmV-V3-QbPOjIo3QiAc8jyH8L6EPOXsjDPdnG_WZ6xjXKDgive9qFRzjyx4JWRRM8XukwVjkhdciOaEPIrxM2OsEk3zkJyU-UHyii3IjzV4ExAiXdqEga7cN-dv6KvJT4F-cL3HHf2EIc6RXrlxHhJ4nPJw1IoDswng43YAn17Spc8Hhl10kU6Wplukl-EGPF2HycwBR_TpL4F-xPR9Cl_Or71L2B_HO3WvXd1C-PUpSNBBxMfkgYUh4pPDfUqu37zeXLwrVpdv318sV4WRnKeCawl1Z3voalnqUtallrVFsKUwSrPOSlWrGjrNmKmMVkYplJXgNeZkGluLU_Jiv3cbpq8zxtSOLhochn0GbVNlXJSM_Z8UItejG5lJsSdNmGIMaNttcCOEXctZe1dru1m3_9aarWeH_XM3Yv_bOfaYgecHAKKBweZwjYt_uFLripeN-AnPnK4m</recordid><startdate>20100627</startdate><enddate>20100627</enddate><creator>POOMMIPANIT, Neda</creator><creator>SANTOS SAMPAIO, Marcelo</creator><creator>CHO, Yong</creator><creator>YOUNG, Brian</creator><creator>SHAH, Tariq</creator><creator>PHAM, Phuong-Thu</creator><creator>WILKINSON, Alan</creator><creator>DANOVITCH, Gabriel</creator><creator>BUNNAPRADIST, Suphamai</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20100627</creationdate><title>Pancreas After Living Donor Kidney Versus Simultaneous Pancreas-Kidney Transplant: An Analysis of the Organ Procurement Transplant Network/United Network of Organ Sharing Database</title><author>POOMMIPANIT, Neda ; SANTOS SAMPAIO, Marcelo ; CHO, Yong ; YOUNG, Brian ; SHAH, Tariq ; PHAM, Phuong-Thu ; WILKINSON, Alan ; DANOVITCH, Gabriel ; BUNNAPRADIST, Suphamai</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-194a6bfdab64292462946feaf23c890bf48686ab900c5c98c88e45316e1507f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Clinical death. Palliative care. Organ gift and preservation</topic><topic>Databases, Factual</topic><topic>Diabetes Complications</topic><topic>Diabetes Mellitus, Type 1 - therapy</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Kidney Transplantation - methods</topic><topic>Living Donors</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pancreas - physiology</topic><topic>Pancreas Transplantation - methods</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Tissue and Organ Procurement - methods</topic><topic>Tissue, organ and graft immunology</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>POOMMIPANIT, Neda</creatorcontrib><creatorcontrib>SANTOS SAMPAIO, Marcelo</creatorcontrib><creatorcontrib>CHO, Yong</creatorcontrib><creatorcontrib>YOUNG, Brian</creatorcontrib><creatorcontrib>SHAH, Tariq</creatorcontrib><creatorcontrib>PHAM, Phuong-Thu</creatorcontrib><creatorcontrib>WILKINSON, Alan</creatorcontrib><creatorcontrib>DANOVITCH, Gabriel</creatorcontrib><creatorcontrib>BUNNAPRADIST, Suphamai</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>POOMMIPANIT, Neda</au><au>SANTOS SAMPAIO, Marcelo</au><au>CHO, Yong</au><au>YOUNG, Brian</au><au>SHAH, Tariq</au><au>PHAM, Phuong-Thu</au><au>WILKINSON, Alan</au><au>DANOVITCH, Gabriel</au><au>BUNNAPRADIST, Suphamai</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pancreas After Living Donor Kidney Versus Simultaneous Pancreas-Kidney Transplant: An Analysis of the Organ Procurement Transplant Network/United Network of Organ Sharing Database</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2010-06-27</date><risdate>2010</risdate><volume>89</volume><issue>12</issue><spage>1496</spage><epage>1503</epage><pages>1496-1503</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>One of the alternative options to simultaneous pancreas-kidney transplantation (SPKT) for type I diabetics with renal failure is sequential transplant of a living donor kidney followed by a deceased donor pancreas transplant (pancreas after living donor kidney transplant [PALK]). We retrospectively compared the outcomes of SPKT versus PALK.
Adults (age 18-59 years) with type I diabetes who were waitlisted for kidney-pancreas and received a SPKT or PALK between 2000 and 2007 were studied. We compared patient, kidney graft, and pancreas graft survival. Multivariate analysis was performed, and the results were expressed as hazard ratios (HRs) of graft loss and death of PALK, with SPKT as a reference.
Of 11,966 patients who received a kidney transplant, 807 received a PALK and 5580 received a SPKT. Median time to pancreas from kidney transplant was 336 (25%-75%: 185-602 days) days. Average hospital stay for SPKT recipients was 13.2+/-15 days, whereas for PALK recipients was 5.7+/-4 days and 9.5+/-8 days for kidney and pancreas transplants, respectively. After controlling for confounding factors, patients receiving PALK had better patient survival (HR 0.52; 95% confidence interval [CI] 0.39-0.70) and kidney survival (HR 0.48; 95% CI 0.39-0.60) but worse pancreas survival (HR 1.37; 95% CI 1.16-1.62) compared with SPKT.
Among those who were waitlisted for a kidney-pancreas transplant, 53% received a kidney-pancreas transplant. Of those who received a kidney-pancreas transplant, 87% patients underwent SPKT and 13% underwent PALK. PALK was associated with better kidney graft and patient survival compared with SPKT. We found an inferior pancreas graft survival and longer total transplant hospitalization in PALK.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>20414150</pmid><doi>10.1097/TP.0b013e3181dd3587</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Clinical death. Palliative care. Organ gift and preservation Databases, Factual Diabetes Complications Diabetes Mellitus, Type 1 - therapy Female Fundamental and applied biological sciences. Psychology Fundamental immunology Graft Survival Humans Kidney Transplantation - methods Living Donors Male Medical sciences Middle Aged Pancreas - physiology Pancreas Transplantation - methods Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Tissue and Organ Procurement - methods Tissue, organ and graft immunology United States |
| title | Pancreas After Living Donor Kidney Versus Simultaneous Pancreas-Kidney Transplant: An Analysis of the Organ Procurement Transplant Network/United Network of Organ Sharing Database |
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