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http://hdl.handle.net/2445/202160
Title: | Preemptive simultaneous pancreas kidney transplantation has survival benefit to patients |
Author: | Montagud Marrahi, Enrique Cuadrado Payán, Elena Hermida, Evelyn Cacho, Judit Cucchiari, David Revuelta, Ignacio Del Risco Zevallos, Jimena Esforzado Armengol, Nuria Cofán Pujol, Federico Oppenheimer Salinas, Federico Torregrosa Prats, José Vicente Ferrer Fábrega, Joana Amor, Antonio Esmatjes Mompó, Enric Ramírez Bajo, María José Musquera i Felip, Mireia Cooper, Mathew Bayés Genís, Beatriu Campistol Plana, Josep M. Diekmann, Fritz Ventura Aguiar, Pedro |
Keywords: | Trasplantament renal Diàlisi Kidney transplantation Dialysis |
Issue Date: | 27-May-2022 |
Publisher: | Elsevier B.V. |
Abstract: | Several organ allocation protocols give priority to wait-listed simultaneous kidney-pancreas (SPK) transplant recipients to mitigate the higher cardiovascular risk of patients with diabetes mellitus on dialysis. The available information regarding the impact of preemptive simultaneous kidney-pancreas transplantation on recipient and graft outcomes is nonetheless controversial. To help resolve this, we explored the influence of preemptive simultaneous kidney-pancreas transplants on patient and graft survival through a retrospective analysis of the OPTN/UNOS database, encompassing 9690 simultaneous transplant recipients between 2000 and 2017. Statistical analysis was performed applying a propensity score analysis to minimize bias. Of these patients, 1796 (19%) were transplanted preemptively. At ten years, recipient survival was significantly superior in the preemptive group when compared to the non-preemptive group (78.9% vs 71.8%). Dialysis at simultaneous kidney-pancreas transplantation was an independent significant risk for patient survival (hazard ratio 1.66 [95% confidence interval 1.32-2.09]), especially if the dialysis duration was 12 months or longer. Preemptive transplantation was also associated with significant superior kidney graft survival compared to those on dialysis (death-censored: 84.3% vs 75.4%, respectively; estimated half-life of 38.57 [38.33 -38.81] vs 22.35 [22.17 - 22.53] years, respectively). No differences were observed between both groups neither for pancreas graft survival nor for post-transplant surgical complications. Thus, our results sustain the relevance of early referral for pancreas transplantation and the importance of pancreas allocation priority in reducing patient mortality after simultaneous kidney-pancreas transplantation. |
Note: | Versió postprint del document publicat a: https://doi.org/10.1016/j.kint.2022.04.032 |
It is part of: | Kidney International, 2022, vol. 102, num. 2, p. 421-430 |
URI: | http://hdl.handle.net/2445/202160 |
Related resource: | https://doi.org/10.1016/j.kint.2022.04.032 |
ISSN: | 0085-2538 |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques) |
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