The Impact of One Year Individual or Dual Organ Rejection in Simultaneous Pancreas-Kidney Transplant on Kidney Graft Survival – A UNOS Registry Analysis 2000-2013.
1Medicine/Nephrology, Indiana University, Indianapolis
2Surgery/Transplant, Indiana University, Indianapolis.
Meeting: 2016 American Transplant Congress
Abstract number: 483
Keywords: Kidney/pancreas transplantation, Pancreas transplantation, Rejection, Survival
Session Information
Date: Tuesday, June 14, 2016
Session Name: Concurrent Session: Clinical Pancreas Transplantation 2
Session Time: 4:30pm-6:00pm
Presentation Time: 4:42pm-4:54pm
Location: Room 210
Background: Early Rejection of either organ in Simultaneous Pancreas-Kidney transplants (SPK) is common within the first 1 year. We studied the impact of within 1 year rejection of either pancreas alone (PAR) ,kidney alone (KIR) or both organs (KPR) on kidney graft survival.
Methods: We included all SPK transplants performed as reported in the UNOS/OPTN database from 2000 through Dec 2013 with a minimum of 1 yr follow up.
Results: A total of 11,929 SPK transplants were included in the analyses. Mean age was 41.3+/-8.4, 72.6% Caucasians, 16% African Americans, 61.7% males, mean age at onset of DM 14+/-8.5, 69% on dialysis at time of transplant, mean donor KDPI of 21+/-17, cold ischemic time 12+/-5hours, median wait time on the list of 263 days .
Of the total group, 85% had no organ rejection, while 6.1% had KIR, 4.5% KPR and 4.1% PAR. Total any kidney rejection rate was 10.5% while total any pancreas rejection rate was 8.5%. The DGF rate was 8.2%. Kaplan-Meier kidney graft survival showed no difference between PAR vs no organ rejection while KIR and KPR had significantly inferior survival (p<0.001). 
Hazard Ratio for PAR was non-significant – 0.89(CI 0.73-1.1; p=0.31); KPR significant with odds ratio of 1.75 (CI 1.46-2.1; p<0.001), while KIR had the highest risk (OR 1.86, CI1.60-2.17; p<0.001). In multivariate Cox Regression analysis, KIR and KPR remained an independent risk factor for Kidney Graft loss. 1,3,5,10 year unadjusted kidney graft survival is shown in Table 1.
| Variable | 1yr | 3yr | 5yr | 10yr |
| No Rejection | 93 | 88 | 81 | 62 |
| Pancreas Alone Rejection | 95 | 85 | 79 | 59 |
| Kidney and Pancreas Rejection | 93 | 77 | 69 | 53 |
| Kidney Rejection | 90 | 75 | 65 | 46 |
Conclusion: Compared to data from earlier eras, in todays era of modern immunosuppression, Pancreas Alone rejection in SPK recipients does not have an impact on Kidney Graft survival, whereas kidney rejection remains an independent risk factor.
CITATION INFORMATION: Moinuddin I, Taber T, Yaqub M, Adebiyi O, Mujtaba M, Chen J, Goble M, Mishler D, Fridell J, Sharfuddin A. The Impact of One Year Individual or Dual Organ Rejection in Simultaneous Pancreas-Kidney Transplant on Kidney Graft Survival – A UNOS Registry Analysis 2000-2013. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Moinuddin I, Taber T, Yaqub M, Adebiyi O, Mujtaba M, Chen J, Goble M, Mishler D, Fridell J, Sharfuddin A. The Impact of One Year Individual or Dual Organ Rejection in Simultaneous Pancreas-Kidney Transplant on Kidney Graft Survival – A UNOS Registry Analysis 2000-2013. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-impact-of-one-year-individual-or-dual-organ-rejection-in-simultaneous-pancreas-kidney-transplant-on-kidney-graft-survival-a-unos-registry-analysis-2000-2013/. Accessed October 20, 2020.« Back to 2016 American Transplant Congress