Incremental value of the pancreas allograft to the survival of simultaneous pancreas-kidney transplant recipients.
OBJECTIVE
To quantify the incremental survival benefit of the pancreas allograft in simultaneous pancreas-kidney (SPK) transplant recipients.


METHODS
Data from the national transplant database from 2000 to 2007 were analyzed. SPK recipients who had functioning allografts to 1-year post transplant (n = 3,304) were compared with those who had failure of the renal (n = 233) or pancreatic (n = 112) graft. The main outcome was a projection of 10 life-years of patient survival beyond the first transplant anniversary.


RESULTS
Recipients with function of both organs accrued 9.4 life-years following transplantation. Projected survival in patients with kidney failure was reduced to 2.5 life-years. Pancreas failure reduced predicted survival to 8 life-years. Renal allograft failure impacts life expectancy significantly (adjusted hazard ratio [aHR] 12.13). However, pancreas allograft failure was also associated with reduced survival (aHR 2.62).


CONCLUSIONS
Although the majority of the survival benefit of SPK transplant is due to the renal transplant, pancreas allograft function does contribute to patient survival.
Salvalaggio
Paolo R
PR
Center for Outcomes Research, Saint Louis University School of Medicine, St. Louis, Missouri, USA. psalvala@u.washington.edu
Dzebisashvili
Nino
N
Pinsky
Brett
B
Schnitzler
Mark A
MA
Burroughs
Thomas E
TE
Graff
Ralph
R
Axelrod
David A
DA
Brennan
Daniel C
DC
Lentine
Krista L
KL
D000328:Adult; D016208:Databases, Factual; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D016035:Pancreas Transplantation / Q000401:mortality / Q000502:physiology*; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors; D014184:Transplantation, Homologous; D017211:Treatment Failure; D055815:Young Adult