The survival advantage of pancreas after kidney transplant

被引：46
作者：
Fridell, Jonathan A. [1 ]
Niederhaus, Silke [2 ]
Curry, Michael [3 ]
Urban, Read [3 ]
Fox, Abigail [3 ]
Odorico, Jon [4 ]
机构：
[1] Indiana Univ Sch Med, Dept Surg, Indianapolis, IN 46202 USA
[2] Univ Maryland, Dept Surg, Med Ctr, Baltimore, MD 21201 USA
[3] United Network Organ Sharing, Richmond, VA USA
[4] Univ Wisconsin, Sch Med & Publ Hlth, Madison, WI USA
来源：
AMERICAN JOURNAL OF TRANSPLANTATION | 2019年 / 19卷 / 03期
关键词：
health services and outcomes research; Organ Procurement and Transplantation Network (OPTN); pancreas/simultaneous pancreas-kidney transplantation; patient survival; FREE MAINTENANCE IMMUNOSUPPRESSION; ALEMTUZUMAB INDUCTION; GLOBULIN INDUCTION; STEROID WITHDRAWAL; ELIMINATION; EXPERIENCE; RECIPIENTS;
D O I：
10.1111/ajt.15106
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Patient survival after pancreas after kidney transplant (PAK) has been reported to be inferior to patient survival after simultaneous pancreas-kidney transplant (SPK). The authors examine national data to further explore allograft (kidney and pancreas) and patient survival after PAK. Kaplan-Meier and Cox proportional hazard models were used to analyze Organ Procurement and Transplantation Network data from 1995 to 2010. The analysis compared PAK and SPK candidates and recipients. Kaplan-Meier analysis results showed that PAK after either a living or a deceased donor kidney transplant is associated with increased kidney graft survival compared with recipients with type 1 diabetes who received only a kidney. The best kidney allograft survival was for patients who received a living donor kidney followed by PAK. Receiving a living donor kidney was associated with increased pancreas allograft survival compared with receiving a deceased donor kidney. PAK transplant recipients who receive both organs have a survival advantage compared with uremic candidates who receive neither (SPK waitlist). Compared with uremic diabetic waitlist patients, SPK and PAK recipients showed similar overall patient survival. Successful PAK offers a survival advantage compared with receiving neither a kidney nor a pancreas transplant. These data also suggest that receiving a pancreas (after kidney) transplant may have a protective effect on the kidney allograft.
引用
收藏
页码：823 / 830
页数：8
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