Outcomes of Simultaneous Pancreas and Kidney Transplants Based on Pre-Transplant Time on Dialysis
University of Wisconsin, Madison, WI
Meeting: 2020 American Transplant Congress
Abstract number: A-253
Keywords: Donation, Pancreas transplantation
Session Information
Session Name: Poster Session A: Pancreas and Islet: All Topics
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Among kidney transplant recipients, the duration of pre-transplant dialysis is significantly associated with poor post-transplant outcomes. However, data on outcomes of pre-emptive simultaneous pancreas and kidney (SPK) transplant before requiring dialysis compared to those on dialysis is limited.
*Methods: We analyzed our primary SPK recipients transplanted between 01/2000 and 12/2017. Patients were divided into two groups based on pre-transplant dialysis history of pre-emptive versus non-preemptive. Patients were excluded if they had any previous transplants. Survival of each graft was the primary outcome.
*Results: Of the 644 SPK recipients who fulfilled our selection criteria, 174 were pre-emptive group and 470 were not. None of the baseline characteristics were different between the groups except Caucasians were significantly more common in pre-emptive group (96% vs 88%, p=0.02). Both kidney and pancreas follow up was longer in the preemptive group at 9.1 yrs and 8.5 yrs compared to the non-preemptive at 8.1 and 7.5 yrs ( p=<0.05). The rate of kidney delayed graft function was significantly lower in the pre-emptive group (4%vs 12%, p=0.003). However, there was no statistically significant difference in the uncensored or death censored graft failure (DCGF) of either graft at last follow up. In the multivariate analysis for kidney DCGF, older age was protective (HR: 0.96, 95% CI 0.93-0.98, p=0.002) and non-Caucasian race and rejection within the first year were significantly associated with increased risk of DCGF. For pancreas, older age was protective and higher kidney donor profile index and pancreas rejection within the first year of transplant were associated with increased risk of DCGF. Pre-emptive vs non-preemptive transplant was not associated with survival of either graft, both in multivariate and K-M analysis ( Figure 1 and 2).
*Conclusions: In SPK recipients, pre-transplant dialysis history was not associated with survival of either graft. This could be due to stricter patient selection criteria for SPK compared to kidney transplant alone. More studies are needed in this field.
To cite this abstract in AMA style:
Parajuli S, Swanson K, Patel R, Aziz F, Garg N, Mohamed M, Redfield R, Djamali A, Kaufman D, Odorico J, Mandelbrot D. Outcomes of Simultaneous Pancreas and Kidney Transplants Based on Pre-Transplant Time on Dialysis [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-simultaneous-pancreas-and-kidney-transplants-based-on-pre-transplant-time-on-dialysis/. Accessed May 16, 2025.« Back to 2020 American Transplant Congress