Background: Pancreas transplantation is well established therapy for insulin-dependent diabetic patients. Management of patients with failed graft by retransplantation might be associated with increased technical and immunological failure. The objective of this study was to evaluate the outcome of pancreas retransplantation in our center.

Methods: Our institutional pancreas transplant database was retrospectively reviewed for patient and graft survival rates and technical complications. Data on all pancreas retransplants were compared with our recent series of the first pancreas transplantation.

Results: Between 1994 and 2014 a total of 501 pancreas transplants were performed in our institution, of those 25 were retransplants. In our recent series of the first pancreas transplants between 2000 and 2014 339 simultaneous pancreas kidney (SPK), 39 pancreas alone (PTA) and 15 pancreas after kidney (PAK) transplants were performed. 1- and 5-year patient survival rates were not significantly different among all groups (retransplant 97% and 91%, SPK 95% and 93%, PTA 97% and 89%, PAK 100% and 74%). 1- and 5- year graft survival rates of pancreas retransplants (87% and 64%) were between SPK (87% and 78%) and isolated pancreas transplants (PTA 67% and 51%, PAK 84% and 56%). In pancreas retransplants early relaparotomy rate was 24% (1x bleeding, 2x thrombosis, 1x absces, 1x bowel obstruction, 1x wound dehiscence), 2 grafts were lost because of early thrombosis, 1 graft because of late thrombosis (2 years after the transplant) and 4 grafts failed due to rejection. In one case the reason of graft failure is unknown.

Conclusion: Pancreas retransplantation is a safe procedure and offers outcomes within a range of SPK and PTA transplants in our own series. Therefore, it should be considered in selected patients. Number of surgical complications is acceptable but statistical significance is difficult to assess due to the small number of patients in the retransplant group.

CITATION INFORMATION: Kocik M, Lipar K, Janousek L, Girman P, Fronek J, Saudek F. Pancreas Retransplantation – Is It Worth It? Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress