Evolutive Analysis of a 20-Year Pancreas Transplant Program

M. Perosa,¹ J. Branez,¹ L. Mota,¹ H. Noujaim,¹ B. Zeballos,¹ L. Ianhez,¹ L. Alvim,¹ D. Machado,¹ C. Watanabe,¹ F. Sergi,¹ M. Paredes,¹ T. Genzini-Miranda,² A. Silvestre,³ G. Martinho,⁴ T. Genzini.¹

¹Abdominal Organ Transplantation, Leforte Hospital, Sao Paulo, Brazil
²Medical School, PUC Sorocaba, Sorocaba, Sao Paulo, Brazil
³Medical School, Sao Camilo, Sao Paulo, Brazil
⁴Medical School, Ciências Médicas Santa Casa, Sao Paulo, Brazil.

Meeting: 2018 American Transplant Congress

Abstract number: A343

Keywords: Immunosuppression, Kidney/pancreas transplantation, Outcome, Pancreas transplantation

Session Information

Session Name: Poster Session A: Pancreas and Islet: All Topics

Session Type: Poster Session

Date: Saturday, June 2, 2018

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

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

Location: Hall 4EF

There is a worldwide trend towards a reduction in the annual number of pancreas transplants (PT). In Brazil, only two centers have performed more than 20 PT per year. For this reason, the analysis of a large Brazilian series is of major importance.

We analyzed 731 PT in a 20-year period, divided into 3 groups: ERA 1: PT performed between 1996 and 2003, ERA 2: from 2004 to 2009, ERA 3: from 2010 to 2016.

Overall, 398 simultaneous pancreas-kidney (SPK) and 333 solitary PT (205 pancreas after kidney-PAK and 128 PT alone-PTA) were performed. The distribution of PT categories showed a reduction of SPK and increase of PAK from Era 1 through Era 3 (p <0.001).

Among SPK , there was a lower number of preemptive transplant, from 26.6% in Era 1 to 4.76% in Era 3 (p <0.001) and the use of depleting antibody induction therapy increased from 53.7% to 88. 9% (p <0.001). There was a drastic reduction in the use of bladder drainage from 61.7% to 0 at Era 3 (p <0.001).

Among solitary PT, the age of pancreas donors decreased over time (24.8 in Era 1 x 20.9 years in Era 3, p <0.001) and there was a decrease in PTA (62.5% x 22.1%) and increase in PAK (37.5% x 77.8%, p <0.001). There was no significant difference in 1-year patient and graft survival over the Eras in both SPK and solitary PT.

After 20 years of program, there was a decrease in the number of SPK and increase in PAKs. For SPK, most recipients are now transplanted on dialysis and receive induction therapy. For solitary PT, the number of PTA has decreased and younger donors were selected over Eras. There was a change in the PT technique, migrating from systemic-bladder drainage to portal-enteric (duodenal) in most PT. Patient and graft survivals remained similar throughout the analyzed periods.

CITATION INFORMATION: Perosa M., Branez J., Mota L., Noujaim H., Zeballos B., Ianhez L., Alvim L., Machado D., Watanabe C., Sergi F., Paredes M., Genzini-Miranda T., Silvestre A., Martinho G., Genzini T. Evolutive Analysis of a 20-Year Pancreas Transplant Program Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Perosa M, Branez J, Mota L, Noujaim H, Zeballos B, Ianhez L, Alvim L, Machado D, Watanabe C, Sergi F, Paredes M, Genzini-Miranda T, Silvestre A, Martinho G, Genzini T. Evolutive Analysis of a 20-Year Pancreas Transplant Program [abstract]. https://atcmeetingabstracts.com/abstract/evolutive-analysis-of-a-20-year-pancreas-transplant-program/. Accessed November 21, 2024.

« Back to 2018 American Transplant Congress