Abstract: FR-PO819
Effect of Delayed Graft Function on Early Pancreatic Graft Failure in Simultaneous Pancreas-Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - Outcomes
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Daoud, Ahmed, Medical University of South Carolina, Charleston, United States
- Su, Zemin, Medical University of South Carolina, Charleston, South Carolina, United States
- Uehara, Genta, Medical University of South Carolina, Charleston, South Carolina, United States
- Soliman, Karim M., Medical University of South Carolina, Charleston, South Carolina, United States
- Posadas, Maria Aurora C., Medical University of South Carolina, Charleston, South Carolina, United States
- Taber, David J., Medical University of South Carolina, Charleston, South Carolina, United States
- Dubay, Derek, Medical University of South Carolina, Charleston, South Carolina, United States
- Casey, Michael, Medical University of South Carolina, Charleston, South Carolina, United States
Background
A recent single center study suggests kidney DGF may be a risk factor for early pancreas graft failure in simultaneous pancreas-kidney transplants (SPK). We explore whether kidney DGF continues to be a risk factor for early pancreas graft failure in a national database study.
Methods
We analyzed the SRTR database for all adult SPK recipients from 2000-2018. Our primary outcome was pancreas graft failure <=90 days. We determined the association between kidney DGF and pancreatic graft failure. We adjusted for recipient age, gender, race, PRA, HLA mismatch, transplant era, and pretransplant dialysis, as well as donor age, gender, race & donation after cardiac death.
Results
15512 adult SPK recipients were identified with 1258 (8.1%) with kidney DGF. 90-day pancreas transplant survival with and without kidney DGF was 81.8% and 92.4% (Figure 1). After adjusting for covariates, kidney DGF was associated with a higher risk of early pancreas loss versus non-DGF (HR 2.457, 95% CI 2.121-2.846, p<0.0001). Other risk factors for early pancreas loss include female recipient, obesity, peak PRA 80-100%, & donor age. Pretransplant dialysis and transplants after 2009 were associated with a lower risk of early pancreas failure (Table 1).
Conclusion
Our study suggests that kidney DGF may be a major risk factor for early pancreas graft failure in SPK recipients. Future studies are still needed.
Cox regression for time to Pancreas Graft Loss within 90 days after transplant
| Variable | HR | 95%CI | P-value |
| Kidney DGF | 2,457 | 2.121-2.846 | <0.0001 |
| Female recipient | 1,151 | 1.028-1.287 | 0.0145 |
| Recipient BMI (Ref=30+) | |||
| <18 | 0.62 | 0.372-1.033 | 0.0667 |
| 18-<30 | 0.708 | 0.608-0.823 | <0.0001 |
| Peak PRA (ref=<1%) | |||
| 80-100% | 1.406 | 1.00-1.975 | 0.0498 |
| Transplant Era (ref-=2000-2009) | |||
| 2010-2018 | 0.836 | 0.726-0.962 | 0.0052 |
| Pretransplant Dialysis | 0.822 | 0.716-0.943 | 0.0052 |
| Donor Age (ref=<18) | |||
| 18-34 | 1.208 | 1.035-1.412 | 0.0168 |
| 35-49 | 1.599 | 1.335-1.915 | <0.0001 |
| 50+ | 2.681 | 1.948-3.692 | <0.0001 |