title: Long-term pancreas allograft survival in simultaneous pancreas-kidney transplantation by era: UNOS registry analysis.
abstract: OBJECTIVE
  To determine whether short-term improvement in pancreas graft survival with simultaneous pancreas-kidney (SPK) transplants translated into improved long-term survival, then to examine the implications of that determination.
  
  
  METHODS
  We analyzed data for 14,311 diabetic patients who received a first SPK transplant between October 1987 and November 2007, using Kaplan-Meier analysis for graft survival rates and Cox regression analysis for year-of-transplant effect.
  
  
  RESULTS
  Overall, from 1995 to 2004, 5-year pancreas graft survival stayed about the same (70-71%). Limiting analysis to grafts that survived more than 1 year, 5-year survival from 1987 to 2004 ranged from 80 to 84%. With 1987-1989 as reference, the adjusted hazard ratio for graft failure by year of transplant increased to 1.49 (95% CI 0.97-2.30) in 2000-2004.
  
  
  CONCLUSIONS
  Long-term pancreas graft survival has remained unchanged despite the dramatic decreases in technical failures and early acute rejection rates that have contributed to prolonged SPK graft survival.
authors.affiliation: Terasaki Foundation Laboratory, Los Angeles, California, USA. kwaki@terasakilab.org
authors.forename: Kayo
authors.initials: K
authors.lastname: Waki
authors.forename: Paul I
authors.initials: PI
authors.lastname: Terasaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Kadowaki
mesh_terms: D000328:Adult; D005260:Female; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D016016:Proportional Hazards Models; D055815:Young Adult
references.citation: J Investig Med. 1996 Dec;44(9):549-55
references.pmid: 9035608
references.citation: Clin J Am Soc Nephrol. 2009 Apr;4(4):845-52
references.pmid: 19201918
references.citation: Clin Transplant. 2005 Aug;19(4):433-55
references.pmid: 16008587
references.citation: Transplant Proc. 2007 Sep;39(7):2323-5
references.pmid: 17889177
references.citation: J Clin Endocrinol Metab. 1998 Jun;83(6):1868-74
references.pmid: 9626111
references.citation: Acta Chir Belg. 2008 May-Jun;108(3):367-78
references.pmid: 18710120
references.citation: Transplantation. 2004 Dec 27;78(12):1802-8
references.pmid: 15614154
references.citation: Clin Transpl. 2007;:9-17
references.pmid: 18637455
references.citation: Lancet. 1994 Jan 1;343(8888):27-31
references.pmid: 7905046