Impact of Pretransplant C-Reactive Protein, Neutrophiles, Platelets, and Albumin Levels on Recipient Survival After Simultaneous Pancreas and Kidney Transplantation

Abstract

BackgroundLong-lasting diabetes mellitus type 1 and end-stage renal disease induce severe metabolic and immunological deterioration. Pretransplant C-reactive protein (CRP) and albumin (ALB) levels have impact on kidney transplantation. We evaluated impact of preoperative CRP, ALB, neutrophiles (NEU) and platelets (PLT) count, on one- and five-year recipients survival after simultaneous pancreas and kidney transplantation (SPK). MethodsAmong 103 SPK recipients, parameters: CRP (mean: 4.5±4.97mg/L); NEU (mean: 5.12 ±2.13∗103/mm3); PLT (mean: 244±84∗103/mm3); ALB (mean 4.5±0.75 g/dL) were obtained before transplantation. Cox regression, uni-, multivariate analysis for one- and five-year survivals were performed with 95% Confidence Intervals (CI) and area under ROC curve (AUC) was assessed. ResultsIn Cox regression, ALB <3,65g/dL had significant impact for one-year and five-year survivors with hazard ratios: 8 (CI:1.5-38.28, p<0.05) and 3.13 (CI:1.45-6.73, p<0.05), respectively. In univariate analysis, we found significantly decreased one-year survival if: PLT<180∗103/mm3, ALB <3.65g/dL, NEU>5.8∗103/mm3 and CRP>2.25mg/L with odds ratios (OR): 6.75 (CI: 2.12-21.15); 4.05(CI:1.3-12.09); 2.97 (CI: 1.02-8.64) and 5.51 (CI:1.67-18.19), respectively. Independent factors for five-year survival were: CRP, ALB and PLT with OR: 4.72(CI:1.67–13.29); 3.31(CI:1.18–9.25) and 4.2(CI:1.39–12.68), respectively. In multivariate analysis, we built two models for one-year survival. Model 1 (ALB+PLT) with OR: 3.12 (CI:0.97-10.07) and 5.55 (CI:1.67-18.4); and model 2 (CRP+PLT) with OR: 5.51 (CI:1.5-17.3) and 4.3 (CI:1.2-15.06), respectively. AUC for models 1 and 2 were: 0.74 and 0.759, respectively. ConclusionsNEU, PLT, ALB and CRP levels assessed before transplantation are independent factors for one- and five-year SPK recipients survival.