Thirty Years of Pancreas Transplantation at Leiden University Medical Center: Long-term Follow-up in a Large Eurotransplant Center. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Kopp, Wouter H.; Verhagen, Merel J. J.; Blok, Joris J.; Huurman, Volkert A. L.; de Fijter, Johan W.; de Koning, Eelco J.; Putter, Hein; Baranski, Andzrej G.; Schaapherder, Alexander F. M.; Braat, Andries E.; Ringers, Jan
• Is Part Of: Transplantation. Volume 99:Issue 9(2015)
• Publication Date: 2015-09
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000000604
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Background: An overview of 30 years of pancreas transplantation at a high volume center. Analysis of patient survival– and graft survival–associated risk factors. Methods: All pancreas transplantations performed in our center from January 1, 1984, till December 31, 2012, were evaluated. Covariates influencing pancreas graft survival were analyzed using both univariate and multivariate analysis and Kaplan-Meier analysis. Results: In the study period, 349 pancreas transplantations were performed. With the introduction of modern induction therapy in 1999, 5-year patient survival improved to 92.0% ( P = 0.003). Five-year pancreas graft survival improved to 80.3% ( P = 0.026). Pancreas graft survival was influenced by left or right donor kidney, transplant type, local origin of procurement team, pancreas cold ischemia time, recipient cerebrovascular disease. Pancreas donor risk index increased to 1.39 over the years and pancreas donor risk index 1.24 or higher is a risk factor for graft survival ( P = 0.007). Conclusions: This study has shown excellent results in patient and pancreas graft survivals after 30 years of pancreas transplantation in a high volume center. Different donor, transplant, and recipient related risk factors influence pancreas graft survival. Even with higher risk pancreas donors, good results can be achieved. Abstract : Improvements in patient and graft survival due to improvements in immunosuppression, surgical experience, and donor risk stratification are examined in this 30-year, single-center retrospective study of pancreas transplantation. Supplemental digital content is available in the text.