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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/195427
Outcomes of pancreas transplantation in older diabetic patients
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Objective: Improvement in insulin alternatives is leading to a delayed presentation of microvascular and macrovascular complications of diabetes. The objective of this study was to evaluate the long-term outcomes of older (≥50 years) diabetic patients who receive a pancreas transplantation (PT). Research design and methods: We retrospectively evaluated all 338 PTs performed at our center between 2000 and 2016 (mean follow-up 9.4±4.9 years). Recipient and graft survivals were estimated for up to 10 years after PT. Major adverse cardiovascular events (MACEs) before and after PT were included in the analysis. Results: Thirty-nine patients (12%) were ≥50 years old (52.7±2.3 years) at the day of PT, of which 29 received a simultaneous pancreas-kidney transplantation (SPK) and 10 a pancreas after kidney transplantation (PAK). SPK recipients were first transplants, whereas in the PAK up to 50% were pancreas re-transplantations. Recipient and pancreas graft survivals at 10 years were similar between the group <50 years old and the older group for both SPK and PAK (log-rank p>0.05). The prevalence of MACE prior to PT was similar between both groups (31% vs 29%). Following PT, older recipients presented inferior post-transplant MACE-free survival. In a multivariate regression model, diabetes vintage (HR 1.054, p=0.03) and pre-transplantation MACE (HR 1.98, p=0.011), but not recipient age (HR 1.45, p=0.339), were associated with post-transplant MACE. Conclusions: Long-term survival of older pancreas transplant recipients are similar to younger counterparts. Diabetes vintage, but not age, increased the risk of post-transplantation MACE. These results suggest pancreas transplantation is a valuable treatment alternative to older diabetic patients.
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MONTAGUD MARRAHI, Enrique, MOLINA ANDÚJAR, Alícia, PANÉ, Adriana, RAMÍREZ BAJO, María josé, AMOR FERNÁNDEZ, Antonio, ESMATJES MOMPÓ, Enric, FERRER FÁBREGA, Joana, MUSQUERA I FELIP, Mireia, DIEKMANN, Fritz, VENTURA AGUIAR, Pedro. Outcomes of pancreas transplantation in older diabetic patients. _BMJ Open Diabetes Research & Care_. 2020. Vol. 8, núm. 1, pàgs. e000916. [consulta: 28 de gener de 2026]. ISSN: 2052-4897. [Disponible a: https://hdl.handle.net/2445/195427]