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Increased Risk of Early Graft Loss in Pancreas Transplant: A Retrospective Review of the UNOS Database

E. Steen,1 C. Liu,2 E. Siskind,2 J. Ortiz.1

1Surgery, University of Toledo Medical Center, Toledo, OH
2Surgery, Inova Fairfax Hospital, Annandale, VA.

Meeting: 2018 American Transplant Congress

Abstract number: A366

Keywords: Graft failure, Graft function, Pancreas

Session Information

Date: Saturday, June 2, 2018

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

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

 Presentation Time: 5:30pm-7:30pm

Location: Hall 4EF

Related Abstracts
  • Impact of Early Pancreas Graft Failure on Patient and Kidney Graft Survival After Simultaneous Pancreas and Kidney Transplantation (SPK).
  • Is Delayed Graft Function in Simultaneous Kidney-Pancreas Transplant Recipients Associated with an Increased Risk of Pancreas Graft Failure?

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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To cite this abstract in AMA style:

Steen E, Liu C, Siskind E, Ortiz J. Increased Risk of Early Graft Loss in Pancreas Transplant: A Retrospective Review of the UNOS Database [abstract]. https://atcmeetingabstracts.com/abstract/increased-risk-of-early-graft-loss-in-pancreas-transplant-a-retrospective-review-of-the-unos-database/. Accessed December 8, 2019.

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