Abstract
Early pancreas loss in simultaneous pancreas-kidney (SPK) transplants has been associated with longer perioperative recovery and reduced kidney allograft function. We assessed the impact of early pancreas allograft failure on transplant outcomes in a contemporary cohort of SPK patients (n=218). Early pancreas allograft loss occurred in 12.8% (n=28) of recipients. Delayed graft function (DGF) was more common (21.4% vs. 7.4%, p=0.03) in the early pancreas loss group, but there were no differences in hospital length of stay (median 6.5 vs. 7.0, p=0.22), surgical wound complications (p=0.12), or rejection episodes occurring in the first year (p=0.87). Despite differences in DGF, both groups had excellent renal function at 1year post-transplant (eGFR 64.1±20.8 vs. 65.8±22.9, p=0.75). There were no differences in patient (HR 0.58, 95% CI 0.18-1.87, p=0.26) or kidney allograft survival (HR 0.84, 95% CI 0.23-3.06, p=0.77). One- and 2-year protocol kidney biopsies were comparable between the groups and showed minimal chronic changes; the early pancreas loss group showed more cv changes at 2years (p=0.04). Current data demonstrate good outcomes and excellent kidney allograft function following early pancreas loss.
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