title: Outcomes of pancreas retransplantation after simultaneous kidney-pancreas transplantation are comparable to pancreas after kidney transplantation alone.
abstract: BACKGROUND
  There is a paucity of contemporary data describing the results of pancreas retransplantation (PRT). As a measure of utility, we wished to determine whether PRT could produce equivalent short-term and long-term recipient outcomes to primary pancreas after kidney (PAK) transplantation.
  
  
  METHODS
  Retrospective analysis of 96 consecutive pancreas only transplants performed from 2003 to May 2012. Primary PAK transplants (n = 78) were compared to PRT (n=18).
  
  
  RESULTS
  Donor and recipient demographics were similar. Pancreas graft survival was similar for PAK and PRT at 1 year (88.2% vs. 100%) and 3 years (85.1% vs. 85.1%). Pancreas graft failure occurred in 14 PAK and two PRT patients with a mean follow-up of 61.6 ± 38.7 and 37.8 ± 26.1 months, respectively. There were no differences in postoperative length of stay (9.9 days vs. 8.7 days; P = 0.9) or postoperative complications in the first 3 months (47.4% vs. 38.9%, P = 0.6). At 3-year follow-up, both groups had comparable HBA1c (0.06 vs. 0.05; P = 0.8), serum creatinine (116.6 μmol/L v 131.7 μmol/L; P = 0.09), and oral glucose tolerance tests.
  
  
  CONCLUSIONS
  Pancreas retransplantation is a safe and effective therapy for select recipients after graft loss. Pancreas retransplantation is associated with the same risk of postoperative complications and has similar intermediate-term graft survival compared to primary PAK transplantation.
authors.affiliation: 1 Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada. 2 Department of Medicine, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Seal
authors.forename: Markus
authors.initials: M
authors.lastname: Selzner
authors.forename: Jerome
authors.initials: J
authors.lastname: Laurence
authors.forename: Max
authors.initials: M
authors.lastname: Marquez
authors.forename: Fateh
authors.initials: F
authors.lastname: Bazerbachi
authors.forename: Ian
authors.initials: I
authors.lastname: McGilvray
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Schiff
authors.forename: Andrea
authors.initials: A
authors.lastname: Norgate
authors.forename: Mark S
authors.initials: MS
authors.lastname: Cattral
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010179:Pancreas; D016035:Pancreas Transplantation / Q000379:methods*; D010182:Pancreatic Diseases / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents