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Cardiovascular Improvement after Pancreatic Transplantation

S. Y. Suen1, T. Sparkes1, R. Kalil2, B. Ravichandran1

1Pharmacy, University of Maryland Medical Center, Baltimore, MD, 2Nephrology, University of Maryland Medical Center, Baltimore, MD

Meeting: 2020 American Transplant Congress

Abstract number: A-259

Keywords: Dyslipidemia, Graft survival, Heart failure, Pancreas transplantation

Session Information

Date: Saturday, May 30, 2020

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

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

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*Purpose: Cardiovascular disease is a common cause of mortality in patients with uncontrolled diabetes. The purpose of this study is to assess whether patients receiving pancreas transplants experience an improvement in overall cardiac function.

*Methods: Adult pancreas transplant patients between 2015-2018 with and without a history of clinical atherosclerotic cardiovascular disease (ASCVD) were included in this study. The primary endpoint of interest was change in cardiac outcome post-transplant, measured by change in surrogate markers, which included the Pooled Cohort 10-Year ASCVD risk score in patients with no ASCVD before transplant and left ventricular ejection fraction (LVEF) in those with ASCVD before transplant. As the risk score includes diabetes as a variable, we aimed to assess cardiovascular outcomes in this population.

*Results: Baseline demographics of 92 pancreas transplant recipients are displayed in Table 1. There were 21 patients with prior ASCVD and 71 patients with no prior ASCVD. A pre-transplant risk score was able to be calculated for 22 (24%) patients. Of 15 pancreas transplant recipients with pre and post-transplant ASCVD risk score, there was a significant reduction in ASCVD risk score post-transplant [8.8% vs. 4.2%, p=.0039, Figure 1]. Of note, only two patients had post-transplant ASCVD events, which occurred on the day of transplant and at five months post-transplant. Of 8 pancreas transplant recipients with pre-transplant ASCVD, there was an improvement in LVEF [60% vs. 67%, p=.0363, Figure 2]. Patient and graft survival at last follow up were 97.8% and 90%.

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*Conclusions: Pancreas transplant recipients with and without ASCVD experienced significant improvements in overall cardiac function, as well as few post-transplant ASCVD events. Although the study was limited by a high number of patients missing pre and post-transplant ASCVD risk scores, the Pooled Cohort 10-Year ASCVD risk calculator appears to serve as a reliable predictor of cardiac outcomes in pancreas transplant recipients without prior clinical ASCVD.

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To cite this abstract in AMA style:

Suen SY, Sparkes T, Kalil R, Ravichandran B. Cardiovascular Improvement after Pancreatic Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/cardiovascular-improvement-after-pancreatic-transplantation/. Accessed February 24, 2021.

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