title: Incidence and Indications for Late Allograft Pancreatectomy While on Continued Immunosuppression.
abstract: There are limited data about the incidence and indications for late allograft pancreatectomy while on continued immunosuppression for functional kidney allografts.
  
  
  
  We analyzed recipients of simultaneous pancreas and kidney and pancreas after kidney transplants between January 1994 and July 2013. Patients with functional kidney but failed pancreas allografts after 90 days were included.
  
  
  
  Out of 1022 simultaneous pancreas and kidney or pancreas after kidney recipients, 246 satisfied these criteria. Of these, 50 underwent allograft pancreatectomy (Px) and 196 did not (no-Px). Eleven of these pancreatectomies were performed at the time of repeat transplant and were analyzed separately. None of the basic recipient or donor characteristics differed significantly between the Px (n = 39) and no-Px groups, except for a higher proportion of females in the Px group. The most common presentation in the Px group was abdominal pain. Histopathology of the pancreas varied widely with graft thrombosis as the most common finding. In univariate and multivariate Cox regression analyses, only female recipient was associated with higher risk for allograft pancreatectomy. Px was not associated with kidney allograft survival (P = 0.16).
  
  
  
  Despite the ongoing presence of full immunosuppression for a functioning kidney allograft, the need for Px for symptoms and radiological findings is not rare (39/246, 15.8%).
authors: 1 Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. 2 Division of Transplant Surgery, University of Wisconsin Hospital and Clinics, Madison, WI. 3 Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors: Sandesh
authors: S
authors: Parajuli
authors: Jon
authors: J
authors: Odorico
authors: Brad C
authors: BC
authors: Astor
authors: Arjang
authors: A
authors: Djamali
authors: Hans
authors: H
authors: Sollinger
authors: Robert
authors: R
authors: Redfield
authors: Dixon
authors: D
authors: Kaufman
authors: Didier A
authors: DA
authors: Mandelbrot
mesh_terms: D000328:Adult; D064591:Allografts; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016035:Pancreas Transplantation / Q000009:adverse effects*; D010180:Pancreatectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents