Long-term Effects of Delayed Graft Function on Pancreas Graft Survival After Pancreas Transplantation.
BACKGROUND
Compared with the impact of delayed graft function (DGF) after renal transplantation, DGF after pancreas transplantation has not been fully evaluated.


METHODS
We retrospectively verified the impact of DGF on long-term pancreas graft survival in surgically successful cases. Pancreas graft failure was defined by the recipient's return to exogenous insulin administration.


RESULTS
Between May 2004 and April 2013, we performed 135 technically successful primary pancreas transplantations. Delayed graft function was defined as a total cumulative insulin requirement of 19 UI or greater within postoperative 7 days. Of the 135 recipients in our study cohort, 47 (34.8%) developed DGF after the pancreas transplantation. By multivariate analysis, DGF was found to be associated with a donor age of 30 years or older (odds ratio, 3.4; 95% confidence interval, 1.50-7.69; P=0.003) and the increased ratio of body mass index in a recipient to a donor (odds ratio, 26.1; 95% confidence interval, 2.53-270.0; P=0.006). There was a trend toward higher acute rejection (P=0.622) and mortality (P=0.49) rates in recipients with versus without DGF, although this did not reach statistical significance. Delayed graft function was found to be associated with a greater risk of overall pancreas graft failure (P=0.016) and death-censored graft failure (P=0.037).


CONCLUSIONS
Delayed graft function after pancreas transplantation was found to be associated with a greater risk of overall pancreas graft failure and death-censored graft failure.
1 Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2 Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea. 3 Address correspondence to: Duck Jong Han, M.D., Ph.D., Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea.
Sung
S
Shin
Duck Jong
DJ
Han
Young Hoon
YH
Kim
Seungbong
S
Han
Byung Hyun
BH
Choi
Joo Hee
JH
Jung
Han Kyung
HK
Cho
D000328:Adult; D051799:Delayed Graft Function / Q000503:physiopathology*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016035:Pancreas Transplantation; D010182:Pancreatic Diseases / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D016896:Treatment Outcome