Risk Factors of Pancreatic Graft Loss and Death of Receptor After Simultaneous Pancreas/Kidney Transplantation

• Published in: Transplantation proceedings 2014-07, Vol.46 (6), p.1827-1835
• Main Authors: Sousa, M.G, Linhares, M.M, Salzedas-Netto, A.A, Gonzalez, A.M, Rangel, E.B, Sá, J.R, Araújo, S.G, Melaragno, C.S, Lopes-Filho, G, Medina Pestana, O.J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Brazil - epidemiology; Diabetes Mellitus - mortality; Diabetes Mellitus - surgery; Female; Graft Rejection - epidemiology; Graft Survival; Humans; Incidence; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - surgery; Kidney Transplantation - adverse effects; Male; Middle Aged; Pancreas Transplantation - adverse effects; Retrospective Studies; Risk Assessment; Risk Factors; Surgery; Survival Rate - trends; Young Adult
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2014.05.048

Abstract Simultaneous pancreas/kidney transplants require a long graft survival and the recipient to present with more benefits than risks. We evaluated the risk factors of receptor's death and pancreatic graft loss on 2 occasions (3 and 12 months' postoperatively) in 292 transplants in whom 22 variables were evaluated. Variables were selected, 9 receivers, 8 donors, and 5 variables related to the surgical procedure. All independent variables were compared with the dependent variables of pancreatic graft losses and patient deaths. Those considered significant according to univariate analysis were analyzed by using multiple logistic regression techniques in an attempt to develop a mathematical model capable of predicting both pancreatic graft and patient losses. Lastly, based on the resulting models with all significant variables, scores were created to determine the risk of patient death and pancreatic graft loss. In the adjusted multivariate analysis, the significant variables were donor age, receiver's body mass index, initial pancreas implant, iliac venous drainage, and use of induction therapy related to pancreatic loss within 3 months after transplantation. Independent risk factors regarding the loss of patients within 12 months were body mass index and receptor induction therapy. The variables related to pancreatic graft loss within 3 months were donor age, receiver body mass index, initial use of pancreatic graft, iliac venous drainage, and induction therapy; these variables can be used for creating a risk score. The donor body mass index and the induction therapy were independently related to patient loss within 12 months after the transplant.