title: Outcomes of Recipients With Pancreas Transplant Alone Who Develop End-Stage Renal Disease.
abstract: Recipients of pancreas transplant alone (PTA) may be at increased risk for developing end-stage renal disease (ESRD). The survival experience of PTA recipients developing ESRD has not been described. Furthermore, the relative survival of these patients as compared to diabetics on chronic dialysis is unknown. We studied all adult PTA recipients from January 1, 1990 to September 1, 2008 using the Scientific Registry of Transplant Recipients. Each PTA recipient developing ESRD was matched to 10 diabetics on chronic dialysis from the United States Renal Data System. Cox proportional hazards models were fitted to determine the relation between ESRD and mortality among PTA recipients, and the relation between PTA and mortality among diabetics on chronic dialysis. There were 1597 PTA recipients in the study, of which 207 developed ESRD. Those with ESRD had a threefold increase in mortality versus those without (adjusted hazard ratio 3.28 [95% confidence interval: 2.27, 4.76]). There was no significant difference in the risk of death among PTA recipients with ESRD versus diabetics on dialysis. PTA recipients developing ESRD are three times more likely to die than PTA recipients without ESRD; however, the risk of death in these patients was similar to diabetics on chronic dialysis without PTA.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.|Division of Nephrology and the Multi-Organ Transplant Program, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: S K
authors.initials: SK
authors.lastname: Singh
authors.affiliation: Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.|Division of Nephrology and the Multi-Organ Transplant Program, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: S J
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Division of Nephrology and the Multi-Organ Transplant Program, McGill University Health Center, McGill University, Montreal, Quebec, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Smail
authors.affiliation: Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.|Division of Nephrology and the Multi-Organ Transplant Program, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Schiff
authors.affiliation: Department of Surgery, Multi-Organ Transplant Program, McGill University Health Center, McGill University, Montreal, Quebec, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Paraskevas
authors.affiliation: Division of Nephrology and the Multi-Organ Transplant Program, McGill University Health Center, McGill University, Montreal, Quebec, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Cantarovich
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000209:etiology*; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000473:pathology; D007677:Kidney Function Tests; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Scientific Registry for Transplant Recipients (SRTR); diabetes; health services and outcomes research; kidney disease; pancreas/simultaneous pancreas-kidney transplantation