title: Pancreas After Islet Transplantation: A First Report of the International Pancreas Transplant Registry.
abstract: Pancreas after islet (PAI) transplantation is a treatment option for patients seeking insulin independence through a whole-organ transplant after a failed cellular transplant. This report from the International Pancreas Transplant Registry (IPTR) and the United Network for Organ Sharing (UNOS) studied PAI transplant outcomes over a 10-year time period. Forty recipients of a failed alloislet transplant subsequently underwent pancreas transplant alone (50%), pancreas after previous kidney transplant (22.5%), or simultaneous pancreas and kidney (SPK) transplant (27.5%). Graft and patient survival rates were not statistically significantly different compared with matched primary pancreas transplants. Regardless of the recipient category, overall 1- and 5-year PAI patient survival rates for all 40 cases were 97% and 83%, respectively; graft survival rates were 84% and 65%, respectively. A failed previous islet transplant had no negative impact on kidney graft survival in the SPK category: It was the same as for primary SPK transplants. According to this IPTR/UNOS analysis, a PAI transplant is a safe procedure with low recipient mortality, high graft-function rates in both the short and long term and excellent kidney graft outcomes. Patients with a failed islet transplant should know about this alternative in their quest for insulin independence through transplantation.
authors.affiliation: University of Arizona, Tucson, AZ.|SUNY Upstate Medical University, Syracuse, NY.
authors.forename: R W G
authors.initials: RW
authors.lastname: Gruessner
authors.affiliation: SUNY Upstate Medical University, Syracuse, NY.|College of Public Health, University of Arizona, Tucson, AZ.
authors.forename: A C
authors.initials: AC
authors.lastname: Gruessner
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D007390:International Agencies; D016381:Islets of Langerhans Transplantation; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors; D055815:Young Adult
keywords: health services and outcomes research; islet transplantation recipient selection; registry / registry analysis; risk assessment / risk stratification; translational research / science pancreas / simultaneous pancreas-kidney transplantation