Montagud Marrahi, EnriqueMolina Andújar, AlíciaPané, AdrianaRamírez Bajo, María JoséAmor Fernández, AntonioEsmatjes Mompó, EnricFerrer Fábrega, JoanaMusquera i Felip, MireiaDiekmann, FritzVentura Aguiar, Pedro2023-03-162023-03-162020-032052-4897https://hdl.handle.net/2445/195427Objective: 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.9 p.application/pdfengcc-by-nc (c) Montagud Marrahi, Enrique et al., 2020https://creativecommons.org/licenses/by-nc/4.0/DiabetisPàncreesTrasplantament d'òrgansTrasplantament renalPersones gransMalalties cardiovascularsDiabetesPancreasTransplantation of organsKidney transplantationOlder peopleCardiovascular diseasesinfo:eu-repo/semantics/article7088932023-03-16info:eu-repo/semantics/openAccess32144128