Kidney Delayed Graft Function Is Associated With Early Pancreas Allograft Failure in Simultaneous Pancreas Kidney Transplant Recipients.

Abstract

We found in a single center study that kidney delayed graft function (DGF) in simultaneous pancreas kidney (SPK) recipients was associated with poor pancreas allograft outcomes. We investigated the association of DGF with SPK outcomes using OPTN data. 14,636 patients received a primary SPK between March 1994 and March 2013. A total of 1,112 (8%) recipients had DGF. Those with DGF were younger, had a higher mean BMI, were more likely to be male, non-Caucasian, less likely to receive a pre-emptive kidney transplant and had donors who were older and had a higher mean BMI. 3219 pancreas allografts failed over a median follow-up of 4.3 years. DGF was associated with early (<30 day) pancreas allograft failure (N=980) (Figure 1A).Figure: No Caption available.DGF remained associated with early pancreas allograft failure after adjustment for recipient and donor age, gender, ethnicity, BMI, pre-transplant dialysis, DCD, infection, leak and pancreatitis (HR=2.35); (Table 1).Table: No Caption available.DGF was not significantly associated with pancreas allograft failure after 30 days (n=2239) in adjusted analysis (HR=1.09). Furthermore, DGF was significantly associated with kidney allograft failure and patient death within 30 days (HR=18.5 and HR=3.15 respectively) and beyond 30 days (HR=1.42 and HR=1.44 respectively) in unadjusted and adjusted analyses (Figure 1B and 1C, Table 1). Kidney DGF is an important risk factor for early pancreas allograft failure in SPK recipients and is also significantly associated with early and longer-term kidney loss and decreased patient survival.