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2022-05-27

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cc-by-nc-nd (c) International Society of Nephrology, 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/202160

Preemptive simultaneous pancreas kidney transplantation has survival benefit to patients

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https://doi.org/10.1016/j.kint.2022.04.032

Resum

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.

Matèries

Trasplantament renal, Diàlisi

Matèries (anglès)

Kidney transplantation, Dialysis

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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, 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 FERNÁNDEZ, 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. Preemptive simultaneous pancreas kidney transplantation has survival benefit to patients. _Kidney International_. 2022. Vol. 102, núm. 2, pàgs. 421-430. [consulta: 24 de gener de 2026]. ISSN: 0085-2538. [Disponible a: https://hdl.handle.net/2445/202160]

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