title: Risk factors and impact of delayed graft function after pancreas transplants.
abstract: Delayed graft function (DGF) occurs after many pancreas transplants (PTx), but is poorly characterized. We studied its incidence, course, and impact in a series of 531 pancreas transplants. Between January 1997 and September 2002, we performed 531 technically successful primary PTx. Of these 531 recipients, 176 (33%) had DGF, defined by their need for exogenous insulin at the time of hospital discharge. The incidence of DGF was roughly equivalent in the three transplant categories: SPK (36%), PAK (32%), and PTA (31%) (p = NS). By 3 months posttransplant, only 19 (3.5%) of all recipients remained on insulin. Only three recipients (0.56%) did not achieve insulin independence. The mean donor age of recipients with DGF was 35.1 years vs. 28.8 years without DGF (p = 0.003). By multivariate analysis, the most significant risk factor for DGF was donor age > 45 years (RR = 4.3, p = 0.0001). For SPK recipients with DGF, graft survival was 87% at 1 year and 82% at 3 years posttransplant; without DGF, 94% at 1 year and 87% at 3 years (p = 0.07). For PAK and PTA recipients, no difference was noted. Acute rejection rates were somewhat higher in recipients with DGF, but this did not reach statistical significance.
authors.affiliation: Department of Surgery, University of Minnesota, Minnesota, MN, USA.
authors.forename: Miguel
authors.initials: M
authors.lastname: Tan
authors.forename: Raja
authors.initials: R
authors.lastname: Kandaswamy
authors.forename: David E R
authors.initials: DE
authors.lastname: Sutherland
authors.forename: Rainer W
authors.initials: RW
authors.lastname: Gruessner
authors.forename: Angelika C
authors.initials: AC
authors.lastname: Gruessner
authors.forename: Abhinav
authors.initials: A
authors.lastname: Humar
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D010179:Pancreas / Q000503:physiopathology*; D016035:Pancreas Transplantation; D012307:Risk Factors; D013997:Time Factors