Long-term pancreas allograft survival in simultaneous pancreas-kidney transplantation by era: UNOS registry analysis.
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.
Waki
Kayo
K
Terasaki Foundation Laboratory, Los Angeles, California, USA. kwaki@terasakilab.org
Terasaki
Paul I
PI
Kadowaki
Takashi
T
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
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