Long-Term Survival after Kidney-Pancreas Transplantation: Lessons from World Largest Series of Long-Term Survivors
University of Wisconsin, Madison, WI
Meeting: 2019 American Transplant Congress
Abstract number: 195
Keywords: Graft function, Graft survival, Pancreas transplantation, Renal function
Session Information
Session Name: Concurrent Session: Pancreas and Islet: All Topics I
Session Type: Concurrent Session
Date: Sunday, June 2, 2019
Session Time: 4:30pm-6:00pm
Presentation Time: 4:42pm-4:54pm
Location: Room 209
*Purpose: Since 1983, more than 1700 patients have undergone pancreas transplant, mainly as a simultaneous-kidney-pancreas transplant (SPK) at our center. Forty-eight SPK recipients have pancreas graft-survival of more than 25 years. Here we present details describing this unique and rare patient population
*Methods: We report data of SPK recipients with pancreas graft survival for more than 25 years, including patients who had functioning grafts by November 2018. Mean post-transplant follow-up was 27.4± 1.9 years.
*Results: Forty-eight SPK recipients with graft survival for more than 25 years transplanted between 1985 and 1993 were analyzed. Forty-seven patients underwent SPK with Bladder Drainage (BD). During the course, 8 patients lost their pancreas and kidney graft after lasting for at least 25 years. Forty still had a functional pancreas graft for more than 25 years as of 10/31/2018. Of these forty SPK recipients, transplanted between 1986 and 1993, 55% were male and all Caucasian. Thirty-nine had BD. OKT3 was used in 33 patients for induction. Overall 3 had pancreas rejection. 27 required enteric conversion. Renal allograft failure occurred in 12 patients and 10 underwent a re-kidney transplant.
Lower extremity amputation was required in 8 patients. Overall only 6 patients were on their original immunosuppressive regimen and 8 were not on a CNI based regimen. At last follow up, 39 recipients had hypertension, 27 had hyperlipidemia and 3 were on low dose insulin or oral agent for diabetes. The mean HgbA1c was 5.6 ± 0.6% and mean serum creatinine was 1.6 ± 0.6 mg/dl.
*Conclusions: With careful and detailed follow-up and attention to complications, some recipients of pancreas grafts have outstanding outcomes. Our report suggests, normalization of glucose control alone does not prevent secondary complications or perhaps immunosuppressive therapy causes secondary complications. As the number of pancreas transplant recipients with prolonged graft survival may be rising, health care providers should be aware of the management of complications associated with prolonged graft survival in this unique group of patients.
To cite this abstract in AMA style:
Parajuli S, Aziz F, Garg N, Muth B, Djamali A, Redfield R, Kaufman D, Odorico J, Mandelbrot D, Sollinger H. Long-Term Survival after Kidney-Pancreas Transplantation: Lessons from World Largest Series of Long-Term Survivors [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/long-term-survival-after-kidney-pancreas-transplantation-lessons-from-world-largest-series-of-long-term-survivors/. Accessed June 7, 2025.« Back to 2019 American Transplant Congress