Background : Pancreas transplantation was considered a therapeutic option for patients with complicated DM. However, in the past decade, the annual number of PT performed in the United States has steadily declined, despite of the setting of improvements in graft and patient survival outcomes and transplanting higher-risk patients. In this study, we analyzed our patients on the waiting list for PT(PTA,SPK,SPLK,PAK) and who received PT already to compare patients' survival

Methods : Retrospective analysis was performed on patients in our center between February 2000 and December 2015. 503 patients (PTA n=116, SPK/SPLK n-303, PAK n=84) on the waiting list and 280 recipients (PTA n=89, SPK, SPLK n=155, PAK n=36) received PT were enrolled. All patients receiving or waiting multi-organ transplant(other than SPK./SPLK) were excluded. Their clinical characteristics and all-cause mortality were analyzed.

Results: 11.9% (60/503) on the waiting list and 4.3% (12/280) on PT group were died. Overall survival of patients was significantly higher in waiting list group for the first year (99.3% vs. 97.8%). However, after then, those were significantly higher in PT group (92.8%, vs, 95.5% in 3 year; 83.1% vs. 94.5 in 7 year, p=0.001). Transplant patient 1- and 3- year survival rates were 99.1 and 97.3, while those on the waiting list were 97.6% and 94.6%, respectively for PTA (p=0.644). For PAK group 1- and 5 year survival rates were 98.8% and 95.9%, while those on waiting list were 100% and 94.7% respectively (p=0.658). Overall relative risk of all-cause mortality for transplant recipients (compared with patients with patients waiting the same procedure) was 1.385 (95% CI, 0.346-5.547; p=0.433) for PTA, 0.614 (95% CI, 0.071-5.292 ; p=0.654) for PAK. However, for SPK/SPLK, that was 0.196(95% CI, 0.088-0.435; p<0.001).

Conclusion :SPK or SPLK can offers considerable survival benefits, despite of their relatively long waiting time, when comparing those of the patients with diabetes on waiting list, especially from 1 year. However, for solitary pancreas transplantation, we should give better attentions to weigh the potential benefit of surgery or waiting.

CITATION INFORMATION: Choi J, Jung J, Chun S, Shin S, Kim Y, Han D. Does Pancreas Transplantation for the Patients with Diabetes Showed Significant Survival Benefit? Am J Transplant. 2017;17 (suppl 3).

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