Impact of pancreatic allograft function on 1-year survival rates after simultaneous pancreatic-renal transplant.
OBJECTIVE
Simultaneous pancreatic-renal transplant is an effective treatment for insulin-dependent patients with chronic renal failure. We sought to identify the main influences on pancreatic and patient survival rates after simultaneous pancreas-kidney transplants.


METHODS
The 1-year patient and pancreas survival rates of 150 patients who had undergone simultaneous pancreas-kidney transplant were analyzed by the Cox proportional hazards regression model and the Kaplan-Meier method. Uni and multivariate analyses were performed in terms of transplant-, recipient-, and donor-related risk factors.


RESULTS
At 1 year, patient and pancreatic allograft survival rates were 82% and 76.7%, respectively. Delayed graft function in the kidney (P = .001, HR 5.41), acute kidney rejection (P = .016, HR 3.36), and intra-abdominal infection (P < .0001, HR 4.15) were the main factors related to 1-year patient survival. Pancreatic allograft survival at 1 year was related to intra-abdominal infection (P < .0001, OR 12.83), vascular thrombosis (P = .002, OR 40.55), acute kidney rejection (P = .027, OR 3.06), donor sodium greater than 155 mEq/L (P = .02, OR 3.27), and dopamine administration exceeding 7.6 microg/kg/min (P = .046, OR 2.85).


CONCLUSIONS
Delayed kidney allograft function and intra-abdominal infection had an important effect on both patient and pancreatic allograft survival rates.
Rangel
Erika B
EB
Universidade Federal de Sao Paulo, Brazil. erikabr@uol.com.br
Melaragno
Claudio S
CS
Gonzalez
Adriano M
AM
Linhares
Marcelo M
MM
de Sa
Joao R
JR
Salzedas
Alcides
A
Medina-Pestana
Jose O
JO