Introduction: Pancreas transplant is an established cure for Type 1 diabetes. Nonetheless, early graft loss is not infrequent. We sought to analyze all of the cases of early graft loss, including patient death.

Methods: The United Network for Organ Sharing (UNOS) database was employed to analyze outcomes of 21,664 pancreas transplants.

Results: We reviewed 149 (0.69%) mortalities, and 1,577 (7.28%) graft failures, occurring within 90 days of pancreas transplant. A multivariate logistic regression model was generated for graft survival and patient survival. The early graft loss group was more likely to receive grafts from donors who were younger (25.5 vs. 28.89 years, p<0.001), and white (compared to Hispanic, p=0.05). For recipients, early graft loss was more common for patients who were older (42.3 v. 40.83 years, p=0.03), had a lower BMI (24.8 v. 25.35, p<0.001), and were white (compared to Hispanic, p=0.004). Patients not on mammalian target of Rapamycin inhibitors (mTORi) were more likely to experience early graft loss (HR=0.474, CI= 0.272-0.824, p<0.001). Fewer significant factors affecting patient survival were recognized when compared to graft survival. However, the odds of mortality for patients with two previous transplant surgeries were increased 6.69 times in comparison to no previous transplant (HR=6.69, CI=2.325-19.248, p<0.001).

Conclusion: Early graft loss was experienced more frequently for white donors and recipients, younger donors, older recipients, recipients with lower BMI and patients not receiving mTORi. The number of previous transplantations poses a serious risk factor for patient mortality. Further studies are needed to investigate individual significant risk factors and their affect on early graft loss.

CITATION INFORMATION: Steen E., Liu C., Siskind E., Ortiz J. Increased Risk of Early Graft Loss in Pancreas Transplant: A Retrospective Review of the UNOS Database Am J Transplant. 2017;17 (suppl 3).

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