title: Impact of delayed pancreatic graft function in simultaneous pancreas-kidney transplantation.
abstract: OBJECTIVE
  Simultaneous pancreas-kidney transplantation is an effective treatment for patients with type 1 diabetes mellitus and end-stage chronic kidney disease. Delayed pancreatic graft function is a common and multifactor condition with significant impact in short-term outcome of simultaneous pancreas-kidney transplantations. The aim of this study was to analyze the impact of pancreatic delayed pancreatic graft function on simultaneous pancreas-kidney transplantation.
  
  
  METHODS
  Donor and recipient's demographic data, percentage of panel reactivity, acute rejection incidence, and patient and grafts survivals were retrospectively analyzed in 180 SPKT performed between 2002 and 2007.
  
  
  RESULTS
  The incidence of pancreatic delayed pancreatic graft function was 11%. Donors older than 45 years had significant risk of pancreatic delayed pancreatic graft function (OR 2.26; p < 0,05). Patients with pancreatic delayed pancreatic graft function had higher rates of acute renal rejection (47 versus 24%; p < 0.05), altered fasting plasma glucose (25 versus 5%; p < 0.05) and mean glycated hemoglobin (5.8 versus 5.4%; p < 0.05), than patients without pancreatic delayed pancreatic graft function at the end of the first year of follow up. There were no significant differences between patients with and without pancreatic delayed pancreatic graft function regarding patient survival (95 versus 88.7%; p = 0.38), pancreatic graft survival (90 versus 85.6%; p = 0.59) and renal graft survival (90 versus 87.2%; p = 0.70), respectively at the sample period of time.
  
  
  CONCLUSIONS
  Pancreatic delayed pancreatic graft function had no significant impact in the short-term outcome of simultaneous pancreas-kidney transplantations. Although delayed pancreatic graft function had no impact on 1-year pancreas graft survival, it contributed to early pancreas graft dysfunction, as assessed by enhanced insulin and oral anti-diabetic drugs requirements.
authors.affiliation: Departamento de Medicina, Universidade Federal de São Paulo, SP, Brasil.
authors.forename: Marina
authors.initials: M
authors.lastname: Baitello
authors.forename: Nelson Zocoler
authors.initials: NZ
authors.lastname: Galante
authors.forename: Luciano de Souza
authors.initials: Lde S
authors.lastname: Coutinho
authors.forename: Erika Bevilaqua
authors.initials: EB
authors.lastname: Rangel
authors.forename: Cláudio Santiago
authors.initials: CS
authors.lastname: Melaragno
authors.forename: Adriano Miziara
authors.initials: AM
authors.lastname: Gonzalez
authors.forename: José O
authors.initials: JO
authors.lastname: Medina-Pestana
mesh_terms: D000293:Adolescent; D000328:Adult; D051799:Delayed Graft Function; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult