Long-Term Results After Simultaneous Pancreas-Kidney Transplantation Using Donors Aged 45 Years or Older

• Published in: Transplantation proceedings 2008-05, Vol.40 (4), p.923-926
• Main Authors: Schenker, P, Wunsch, A, Ertas, N, Schaeffer, M, Rump, L.C, Viebahn, R, Vonend, O
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Biological and medical sciences; Body Mass Index; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - surgery; Diabetic Nephropathies - surgery; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Kidney Failure, Chronic - surgery; Kidney Transplantation - mortality; Kidney Transplantation - physiology; Male; Medical sciences; Middle Aged; Pancreas Transplantation - mortality; Pancreas Transplantation - physiology; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Tissue Donors - statistics & numerical data; Tissue, organ and graft immunology; Treatment Outcome
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2008.03.078

Abstract With the shortage of organ donors, there is a critical need to use all available pancreas grafts for transplantation. Methods From June 1994 to December 2006 we performed 340 pancreas transplantations (317 simultaneous pancreas-kidney 5 pancreas only, 18 pancreas after kidney) including 69 (20%) transplantations from donors aged 45 years or older. Pancreas grafts from older donors were analyzed for graft and patient survival as well as surgical complications, compared with results from younger donors. Results Recipient characteristics were comparable in both groups. The older donor group mean age was 47.8 years (±2.1) versus 27.9 years (±10.3) for the younger group. Cumulative patient survival was 96% versus 98% after 1, 82% versus 91% after 5 and 82% versus 88% after 10 years with 1–5- and 10-year kidney graft survivals of 82%, 72%, 57% versus 93%, 83%, 73%, respectively. Pancreas transplant survival after 1, 5, and 10 years were 69%, 60%, 45% in older and 88%, 76%, and 72% in younger donor cohorts. There were 14 (20%) cases of venous thrombosis in the older group and 25 (9%) in the younger group ( P = .012). Conclusion Our results demonstrated that utilization of pancreas grafts from donors over 45 years resulted in acceptable outcomes after simultaneous pancreas-kidney transplant and could expand the donor pool. Among the older donor group, patient survival was slightly lower than the younger group, whereas pancreas graft function was significantly inferior ( P < .01). Since venous thrombosis was the main reason for pancreas graft loss in older group, anticoagulation is essential.