Center Volume Is Associated with Outcome Following Pancreas Transplantation within the Eurotransplant Region.

W. Kopp,^1,2 M. van Meel,² H. Putter,³ U. Samuel,² H. Arbogast,⁴ W. Schareck,⁵ J. Ringers,¹ A. Braat.¹

¹Surgery, Leiden University Medical Center, Leiden, Netherlands
²Eurotransplant International Foundation, Leiden, Netherlands
³Medical Statistics, Leiden University Medical Center, Leiden, Netherlands
⁴General, Visceral, Transplant, Vascular and Thoracic Surgery, University of Munich &ndash
Grosshadern Medical Centre, Munich, Germany
⁵University Medical Center Rostock, Rostock, Germany.

Meeting: 2016 American Transplant Congress

Abstract number: A51

Keywords: Pancreas transplantation

Session Information

Session Name: Poster Session A: Clinical Pancreas Transplantation and All Islet Cell Transplantation Topics

Session Type: Poster Session

Date: Saturday, June 11, 2016

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Halls C&D

Introduction Outcome following all kinds of surgery depends on several factors, amongst these the annual volume-outcome relationship. This might also be the case in a highly complex field of pancreas transplantation. No study has investigated this relationship in a European setting.

Methods All consecutive pancreas transplantations from January 2008 until December 2013 were included. Donor, recipient and transplant related factors were analyzed for their association with patient and graft survival. Centers were classified in equally sized groups as being low volume (<5 transplantations on average each year in the 5 preceding years), medium volume (5-13/year) or high volume (≥ 13/year).

Results In the study period, 1276 pancreas transplantations were included. Mean duration of follow up was 3.2 (SD 1.8) years. Low volume centers performed 396 (32.6%) transplantations, medium volume 425 (35%) transplantations and high volume 393 (32.4%) transplantations. Unadjusted 1 year patient survival was associated with center volume and was best in high volume centers, compared to medium and low volume: 96.5%, 94% and 92.3%, respectively (p=0.002). Pancreas donor risk index (PDRI) was highest in high volume centers: 1.38 vs. 1.21 in medium and 1.25 in low volume centers, (p<0.001). Unadjusted 1 year death censored pancreas graft survival did not differ significantly between volume categories: 86%, 83.2% and 81.6%, respectively (p=0.110). However, after multivariate Cox-regression analysis, higher PDRI (HR 1.61, p=0.002), retransplantation (HR 1.90, p<0.001) and higher recipient BMI (HR 1.04, p=0.044) were independent risk factors for pancreas graft failure. High center volume was protective for graft failure (HR 0.65, p=0.014) compared to low center volume. Medium volume was protective compared to low volume, albeit not statistically significant (HR 0.87, p=0.367).

Conclusion Patient and graft survival following pancreas transplantation is good in higher volume centers. High volume centers have good results, even though they transplant organs with the highest risk.

CITATION INFORMATION: Kopp W, van Meel M, Putter H, Samuel U, Arbogast H, Schareck W, Ringers J, Braat A. Center Volume Is Associated with Outcome Following Pancreas Transplantation within the Eurotransplant Region. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Kopp W, Meel Mvan, Putter H, Samuel U, Arbogast H, Schareck W, Ringers J, Braat A. Center Volume Is Associated with Outcome Following Pancreas Transplantation within the Eurotransplant Region. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/center-volume-is-associated-with-outcome-following-pancreas-transplantation-within-the-eurotransplant-region/. Accessed November 22, 2024.

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