title: Kidney failure requiring kidney transplantation after pancreas transplant alone.
abstract: Pancreas transplant alone (PTA) is usually performed in type 1 diabetic patients with preserved renal function to correct severe metabolic complications. One of the major concerns is renal failure after PTA. Here, we reported the cumulative incidence of kidney failure requiring kidney transplantation (KF/KT) among PTA recipients in the United States. Using the Organ Procurement Transplant Network/ United Network for Organ Sharing database, all primary adult PTA recipients with estimated baseline glomerular filtration rate (by the Modification of Diet in Renal Disease equation) >or=60 mL/min/1.73m2 were selected (n=1085). KF/ KT after PTA was defined as: wait-listing for or receiving a kidney alone (KA) or simultaneous pancreas kidney (SPK) transplant. The median follow-up time was 1185 days (25-75%: 524-2183). Ten years post PTA, 120 (11.1%) patients developed KF/KT; of those, 70 (6.5%) subsequently received a KA/SPK transplant (56 received KA and 14 received SPK) and 50 (4.6%) recipients were listed without receiving a transplant. The cumulative incidence of KF/KT after PTA at 1, 3, and 5 years after PTA was 0.3, 2.5, and 9.7%, respectively. In conclusion, KF/KT after PTA was not uncommon (9.7% at 5 years), and prospective PTA recipients should be aware of the risks of kidney failure after transplantation.
authors.forename: Naowanit
authors.initials: N
authors.lastname: Nata
authors.forename: Edmund
authors.initials: E
authors.lastname: Huang
authors.forename: Mandana
authors.initials: M
authors.lastname: Kamgar
authors.forename: Napat
authors.initials: N
authors.lastname: Leeaphorn
authors.forename: Alireza
authors.initials: A
authors.lastname: Mehrnia
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.forename: Suphamai
authors.initials: S
authors.lastname: Bunnapradist
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000601:surgery; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology