title: Solitary pancreas transplantation: a review of the UK experience over a period of 10 yr.
abstract: BACKGROUND
  The aim of this study was to see whether lessons could be learned from the prospectively maintained nationwide database on solitary pancreas transplantation (SPTx) performed in the UK.
  
  
  METHODS
  Two hundred and forty-five SPTx were utilized from the 2004-2013 period (113 pancreas transplant alone and 132 pancreas after kidney). The statistical analysis included donor, recipient, transplant variables, and the effect of a rejection episode on graft survival.
  
  
  RESULTS
  Cold ischemia time (CIT), CIT > 12 h, donor body mass index (BMI) > 30, and non-lymphocyte-depleting induction immunosuppression achieved p-value <0.05 in the unadjusted univariate hazard model analysis. In a multivariate analysis, variables that persisted in demonstrating increased independent risk included CIT > 12 h (hazard ratio [HR] 1.94, p = 0.035) and the use of non-depleting induction immunosuppression (HR 1.95, p = 0.002). Factors such as bladder-drained grafts and donor variables including age, BMI, and donation after cardiac death (DCD) vs. donation after brain-stem death did not attain significance. Rejection reduces the overall graft survival by approximately 1000 d (1841 ± 114 d vs. 915 ± 119 d, p = 0.001).
  
  
  CONCLUSIONS
  Cold ischemia time <12 h and the use of depleting antibodies as induction immunosuppression have a positive effect on pancreas allograft survival. Other factors such as bladder-drained grafts and donor variables such as age, BMI, and DCD status did not attain significance in a multivariate analysis.
authors.affiliation: Oxford Transplant Centre, Churchill Hospital, Oxford, UK.
authors.forename: Georgios
authors.identifier: http://orcid.org/0000-0002-9108-4064
authors.initials: G
authors.lastname: Vrakas
authors.affiliation: Oxford Transplant Centre, Churchill Hospital, Oxford, UK.
authors.forename: Rubens Macedo
authors.initials: RM
authors.lastname: Arantes
authors.affiliation: Oxford Transplant Centre, Churchill Hospital, Oxford, UK.
authors.forename: Undine
authors.initials: U
authors.lastname: Gerlach
authors.affiliation: Oxford Transplant Centre, Churchill Hospital, Oxford, UK.
authors.forename: Srikanth
authors.initials: S
authors.lastname: Reddy
authors.affiliation: Oxford Transplant Centre, Churchill Hospital, Oxford, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Friend
authors.affiliation: Oxford Transplant Centre, Churchill Hospital, Oxford, UK.
authors.forename: Anil
authors.initials: A
authors.lastname: Vaidya
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D011379:Prognosis; D011446:Prospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D055815:Young Adult
keywords: isolated; pancreas; solitary; survival; transplantation