Pancreas Re-Transplantation Graft Survival Is Comparable to Primary Pancreas after Kidney Transplantation
Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
Department of Medicine, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
Meeting: 2013 American Transplant Congress
Abstract number: 469
Background: Reports on the outcomes of pancreas re-transplantation are scarce in the modern era. We compared the outcome of pancreas re-transplantation with primary pancreas after kidney (PAK) transplantation at a high volume North American center.
Methods: Retrospective analysis of 70 consecutive pancreas only transplants performed at the Toronto General Hospital from 2003 to May 2012. Primary pancreas after kidney transplants (PAK; n=56) were compared to pancreas re-transplantation (PRT) after pancreas graft loss (n=14). Patient and graft survival were assessed at 1 and 3 year follow-up. Pancreas graft function was determined by HbA1c. Serum creatinine was used to determine kidney graft function. Graft survival, and patient survival were calculated by log rank analysis.
Results: There was no statistical difference in recipient or donor characteristics between the 2 groups including recipient sex, age, weight, and donor age. Pancreas graft cold ischemic time (7.75 vs. 8.25 h p=0.76) and warm ischemic time (26.76 vs. 31 min p=0.51) were comparable. Pancreas graft survival at 1 and 3 year follow-up was similar between PAK (91%, 88%) and PRT (100%, 100%) respectively (p=NS). There were no graft failures in the PRT group during the study interval with a mean follow-up of 35.3 months. Causes of graft loss in the PAK group were rejection (n=7) duodenal leak (n=4) and graft thrombosis (n=3). There was no difference in post-operative length of stay (12.7±11.3 vs. 10.7±6.6 d; p=0.54). There was no difference in the rate of post-operative complications in the first 6 months, except for duodenal leaks, which was lower in the re-transplant group (p=0.03). At 3-years follow-up PAK vs PRT patients had comparable HBA1c (0.08 vs 0.05; p=0.8) and creatinine (116.6 v 131.7; p=0.09). Pancreas re-transplantation did not adversely affect kidney transplant function in the recipient.
Conclusion: Pancreas re-transplantation is safe and effective regardless of cause of prior graft loss with comparable outcomes to first time pancreas after kidney transplant.
To cite this abstract in AMA style:
Seal J, Selzner M, Marquez M, Bazerbachi F, McGilvray I, Schiff J, Norgate A, Cattral M. Pancreas Re-Transplantation Graft Survival Is Comparable to Primary Pancreas after Kidney Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/pancreas-re-transplantation-graft-survival-is-comparable-to-primary-pancreas-after-kidney-transplantation/. Accessed May 17, 2025.« Back to 2013 American Transplant Congress