International Pancreas Transplant Registry report.
From December 1966 to December 1988, 1,830 pancreas transplants were reported to the International Pancreas Transplant Registry. Of these, 1,549 were reported as of June 30, 1988 and analyzed on July 13, 1988. One-year actuarial graft function (insulin-independent) and recipient survival rates for all cases were 42% and 80%, respectively. In an analysis by era of 1966 to 1977 (n = 64), 1978 to 1983 (n = 336), 1984 to 1985 (n = 387), and 1986 to 1988 (n = 762) cases, 1-year graft function rates were 5%, 25%, 41%, and 55% and recipient survival rates were 44%, 72%, 81%, and 88%, respectively (p less than or equal to 0.01 all comparisons). In an analysis of 1984 to 1988 cases only (n = 1,149), the overall 1-year graft function and patient survival rates were 49% and 85%, respectively. During this period, graft functional survival rates for the most common duct management methods were 53% for duct injection (n = 313), 45% for intestinal drainage (n = 257), and 51% for bladder drainage (n = 535) at 1 year (p less than 0.04 for intestinal vs bladder drainage). Graft function rates were similar for whole (n = 552) and segmental (n = 595) pancreas transplants (48% vs 50% at 1 year). Functional survival rates according to duration of preservation for grafts stored less than 6 hours (n = 706), 6-12 hours (n = 243), 12-24 hours (n = 95), and 12-24 hours (n = 9) were 50%, 47%, 43%, and 78% at 1 year, and none of the differences were significant. Graft functional survival rates for 1984 to 1988 cases were significantly higher (p less than 0.05) in recipients who received AZA and CsA in combination (n = 895) than in those who received CsA without AZA (n = 218) or AZA without CsA, (n = 27), with 1-year graft functional survival rates of 52%, 41%, and 33%, respectively. For technically successful grafts, the function survival rates were also significantly higher (p less than 0.05) in recipients treated with CsA + AZA (n = 708) than in those who received CsA without AZA (n = 156) or AZA without CsA (n = 19), with 1-year function rates of 66%, 56%, and 47%, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
Sutherland
D E
DE
Department of Surgery, University of Minnesota Hospital, Minneapolis.
Moudry-Munns
K C
KC
D005060:Europe / Q000453:epidemiology; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007390:International Agencies; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D009656:North America / Q000453:epidemiology; D009926:Organ Preservation; D010043:Outcome and Process Assessment, Health Care; D016035:Pancreas Transplantation / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D010183:Pancreatic Ducts / Q000601:surgery; D012042:Registries; D015996:Survival Rate