title: Thirty Years of Pancreas Transplantation at Leiden University Medical Center: Long-term Follow-up in a Large Eurotransplant Center.
abstract: BACKGROUND
  An overview of 30 years of pancreas transplantation at a high volume center. Analysis of patient survival- and graft survival-associated risk factors.
  
  
  METHODS
  All pancreas transplantations performed in our center from January 1, 1984, till December 31, 2012, were evaluated. Covariates influencing pancreas graft survival were analyzed using both univariate and multivariate analysis and Kaplan-Meier analysis.
  
  
  RESULTS
  In the study period, 349 pancreas transplantations were performed. With the introduction of modern induction therapy in 1999, 5-year patient survival improved to 92.0% (P = 0.003). Five-year pancreas graft survival improved to 80.3% (P = 0.026). Pancreas graft survival was influenced by left or right donor kidney, transplant type, local origin of procurement team, pancreas cold ischemia time, recipient cerebrovascular disease. Pancreas donor risk index increased to 1.39 over the years and pancreas donor risk index 1.24 or higher is a risk factor for graft survival (P = 0.007).
  
  
  CONCLUSIONS
  This study has shown excellent results in patient and pancreas graft survivals after 30 years of pancreas transplantation in a high volume center. Different donor, transplant, and recipient related risk factors influence pancreas graft survival. Even with higher risk pancreas donors, good results can be achieved.
authors.affiliation: 1 Division of Transplantation, Department of Surgery, Leiden University Medical Center, Leiden University, Leiden, the Netherlands. 2 Department of Nephrology, Leiden University Medical Center, Leiden University, Leiden, the Netherlands. 3 Department of Medical Statistics, Leiden University Medical Center, Leiden University, Leiden, the Netherlands.
authors.forename: Wouter H
authors.initials: WH
authors.lastname: Kopp
authors.forename: Merel J J
authors.initials: MJ
authors.lastname: Verhagen
authors.forename: Joris J
authors.initials: JJ
authors.lastname: Blok
authors.forename: Volkert A L
authors.initials: VA
authors.lastname: Huurman
authors.forename: Johan W
authors.initials: JW
authors.lastname: de Fijter
authors.forename: Eelco J
authors.initials: EJ
authors.lastname: de Koning
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.forename: Andzrej G
authors.initials: AG
authors.lastname: Baranski
authors.forename: Alexander F M
authors.initials: AF
authors.lastname: Schaapherder
authors.forename: Andries E
authors.initials: AE
authors.lastname: Braat
authors.forename: Jan
authors.initials: J
authors.lastname: Ringers
mesh_terms: D000046:Academic Medical Centers / Q000639:trends*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D061847:Hospitals, High-Volume / Q000639:trends*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000639:trends*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents