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2020-03

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cc-by-nc (c) Montagud Marrahi, Enrique et al., 2020
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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Recurs relacionat

https://doi.org/10.1136/bmjdrc-2019-000916

Resum

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.

Matèries

Diabetis, Pàncrees, Trasplantament d'òrgans, Trasplantament renal, Persones grans, Malalties cardiovasculars

Matèries (anglès)

Diabetes, Pancreas, Transplantation of organs, Kidney transplantation, Older people, Cardiovascular diseases

Citació

Col·leccions

Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

MONTAGUD MARRAHI, Enrique, et al. Outcomes of pancreas transplantation in older diabetic patients. BMJ Open Diabetes Research & Care. 2020. Vol. 8, num. 1, pags. e000916. ISSN 2052-4897. [consulted: 6 of August of 2026]. Available at: https://hdl.handle.net/2445/195427

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