Abstract
BackgroundWith the rising demands for pancreas transplantation, surgeons are trying to extend the donors pool and set up a more appropriate assessment system. We aim to evaluate the effect of donor hypertension on recipient overall and graft survival rates.MethodsTwenty-four thousand one hundred ninety-two pancreas transplantation patients from the Scientific Registry of Transplant Recipients database were subdivided into hypertension group (HTN, n = 1531) and non-hypertension group (non-HTN, n = 22,661) according to the hypertension status of donors. Recipient overall and graft survival were analyzed and compared by log rank test, and hazard ratios of predictors were estimated using Cox proportional hazard models.ResultsPatient overall and graft survival of non-HTN group were higher than that of the HTN group (both p < 0.001). The duration of hypertension negatively influenced both overall and graft survival rates (both p < 0.001). Multivariate analyses demonstrated that hypertension was an independent factor for reduced survival (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.01–1.18; p < 0.001). Other independent factors included recipient body mass index (HR, 1.02; 95% CI, 1.01–1.05; p < 0.001) and transplant type (pancreas after kidney transplants / pancreas transplant alone vs. simultaneous pancreas-kidney transplants; HR, 1.41; 95% CI, 134–1.55; p < 0.001).ConclusionsDonor hypertension is an independent factor for recipient survival after pancreas transplantation and could be considered in donor selection as well as post-transplant surveillance in clinical practice.
Highlights
With the rising demands for pancreas transplantation, surgeons are trying to extend the donors pool and set up a more appropriate assessment system
Even though minimally invasive approaches, such as islet transplantation, are being developed, pancreas transplantation remains the gold standard endocrine replacement treatment for complicated diabetes patients who cannot be optimally managed with conventional insulin therapy [2]
With analyses of the long-term follow-up data from Scientific Registry of Transplant Recipients, we aim to evaluate the effect of donor hypertension on recipient overall and graft survival in pancreas transplantation
Summary
With the rising demands for pancreas transplantation, surgeons are trying to extend the donors pool and set up a more appropriate assessment system. We aim to evaluate the effect of donor hypertension on recipient overall and graft survival rates. Pancreas transplantation is the main method to reestablish insulin secretion, and is reliable and repeatable for type 1 diabetes while less common for type 2 diabetes [1, 2]. It has been widely accepted that pancreas transplantation is an alternative to continued insulin therapy in imminent or established end-stage renal disease diabetic patients, who need combined kidney and pancreas transplantation to improve survival. Even though minimally invasive approaches, such as islet transplantation, are being developed, pancreas transplantation remains the gold standard endocrine replacement treatment for complicated diabetes patients who cannot be optimally managed with conventional insulin therapy [2]. The pancreas transplantation survival rate has increased with developing techniques. Simultaneous pancreas–kidney transplants (SPK) has the best patient and graft survival, 96% and 83% for 1- and 5-year patient
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