Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: African-American recipients (AA) are considered a high risk group for organ transplantation. As outcomes after pancreas transplantation have significantly improved, the number of transplants in AA have increased considerably. However, no recent outcome information is available.
*Methods: We studied 1,692 primary deceased donor pancreas transplants in AA between 1/2008 and 12/2017. The majority of transplants were simultaneous pancreas/kidney (SPK) transplants (91.2%) followed by Pancreas after Kidney transplants (7.2%). Pancreas transplants alone were rarely performed and accounted for 1.6%. This study concentrates on SPK transplants. Univariate and multivariate methods were used to study outcome and potential donor and recipient risk factors.
*Results: During the analyzed time period the number of pancreas transplants in AA increased significantly from 15% in 2008 to 25% of all pancreas transplants 2017.The indication for SPK transplant was in 83 % type 1 and in 17% type 2 diabetes mellitus (DM); 36% of the recipients were female. About 50% of recipients were overweight or obese and recipients with type 2 DM were significantly more likely to be obese or overweight. Patient survival remained stable over time and reached at 1- (5-)-year 97% (89%). The highest impact on patient survival was a functioning kidney and/or pancreas graft. In addition, each additional year on dialysis pretransplant increased the relative risk (RR) to die by 15%. Younger and older age had a negative impact on patient survival. Diabetes type proved to be non-significant. Pancreas graft functions at 1- (5-) years was 89% (75%). The most influential factor for graft failure was obesity (RR:1.50, p=0.006). Only a slight correlation between type 2 DM and BMI was found where being obese had the higher impact. A cPRA over 20% also significantly increased the risk of pancreas graft failure. In contrast, younger donors and large transplant centers showed significantly better outcomes. Immunologic pancreas graft loss at 1- (5)-year was 2% (11%). Main risk factors were younger recipient age, no use of depleting antibody therapy for induction, early treatment for rejection and 2 antigen HLA B-mismatches. Kidney graft survival at 1- (5-) was 95% (78%). Donor and recipient age, obesity and gender had a significant impact on kidney graft survival. The use of enteric drainage significantly lowered the risk of kidney graft loss.
*Conclusions: This study shows that pancreas transplantation is associated with excellent outcome in AA recipients and should be made available for this group of patients.
To cite this abstract in AMA style:Gruessner A, Saggi S, Gruessner RW. Excellent Outcome in African-American (AA), Type 1 and Type 2 Diabetic Recipients after Simultaneous Pancreas and Kidney Transplantation (SPK) [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/excellent-outcome-in-african-american-aa-type-1-and-type-2-diabetic-recipients-after-simultaneous-pancreas-and-kidney-transplantation-spk/. Accessed April 8, 2020.
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