Donor age is the most important predictor of long term graft function in donation after cardiac death simultaneous pancreas-kidney transplantation: A retrospective study.
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
18
11
2018
revised:
05
02
2019
accepted:
14
02
2019
pubmed:
16
3
2019
medline:
5
3
2020
entrez:
16
3
2019
Statut:
ppublish
Résumé
Allografts donated after cardiac death (DCD) are the fastest growing organ source worldwide. Unfortunately, information is lacking on how to judge these organs' viability. Here, we analyzed the effects of donor characteristics, including age and BMI, on outcomes of DCD simultaneous-pancreas-kidney transplantation (SPK). We evaluated UNOS DCD-SPK transplants from 1988 to 2012. Effects of donor characteristics on graft and recipient survival were evaluated using Cox Regression and the Kaplan-Meier method, and compared to predictions from the pancreas and kidney donor risk indices (PDRI, KDRI). Compared to grafts≤40(n = 38), grafts>40(n = 189) had lower 1-year (73.4% ± 7.2% vs 88.2% ± 2.4%) and 10-year (50.3% ± 10% vs 66.3% ± 6.9%) pancreas survival, and twice the rate of kidney failure (HR2.1, 95%CI 1.15-3.83, p < 0.05) and pancreas failure (HR2.07, 95%CI 1.16-3.70, p < 0.05). BMI correlated with pancreas failure and recipient mortality. Donor age and BMI are significant predictors of DCD-SPK outcomes. Graft age appears to be as good a predictor of outcome as PDRI and KDRI.
Sections du résumé
BACKGROUND
Allografts donated after cardiac death (DCD) are the fastest growing organ source worldwide. Unfortunately, information is lacking on how to judge these organs' viability. Here, we analyzed the effects of donor characteristics, including age and BMI, on outcomes of DCD simultaneous-pancreas-kidney transplantation (SPK).
METHODS
We evaluated UNOS DCD-SPK transplants from 1988 to 2012. Effects of donor characteristics on graft and recipient survival were evaluated using Cox Regression and the Kaplan-Meier method, and compared to predictions from the pancreas and kidney donor risk indices (PDRI, KDRI).
RESULTS
Compared to grafts≤40(n = 38), grafts>40(n = 189) had lower 1-year (73.4% ± 7.2% vs 88.2% ± 2.4%) and 10-year (50.3% ± 10% vs 66.3% ± 6.9%) pancreas survival, and twice the rate of kidney failure (HR2.1, 95%CI 1.15-3.83, p < 0.05) and pancreas failure (HR2.07, 95%CI 1.16-3.70, p < 0.05). BMI correlated with pancreas failure and recipient mortality.
CONCLUSIONS
Donor age and BMI are significant predictors of DCD-SPK outcomes. Graft age appears to be as good a predictor of outcome as PDRI and KDRI.
Identifiants
pubmed: 30871789
pii: S0002-9610(18)31524-1
doi: 10.1016/j.amjsurg.2019.02.024
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
978-987Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.