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 August 4, 2021.
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