Prior renal transplant patients demonstrate similar outcomes following pancreatectomy

Abstract

Introduction: The purpose of our study was to evaluate clinical outcomes of previous kidney transplant recipients (KTxRs) undergoing pancreatectomy. Methods: We queried the National Inpatient Sample (NIS) database from 2005 to 2014 to identify KTxRs with pancreatic lesions (case group) who underwent partial or total pancreatectomy. Propensity matching was used to create a comparative control group of non-KTxRs. Chi-square analyses were utilized to compare the clinical variables between groups, while regression analyses were utilized to compare clinical outcomes as well as hospital charges. Results: Twenty-five pancreatectomy patients had also undergone prior kidney transplant. KTxRs were more likely to have a benign tumor type (32.0% vs. 14.4%, p=0.020). The KTxR population utilized a greater percentage of government-based health insurance (72.0% vs. 50.0%, p=0.028). On univariate analysis, KTxRs demonstrated a higher rate of blood transfusion during pancreatectomy (40.0% vs 22.2%, p=0.032), and the average total hospital charge for these patients was significantly greater ($108,218 vs $85,858, p=0.047). However, prior receipt of a kidney transplant was not associated with increased mortality, morbidity, length of stay, or total hospital charges on multivariate analysis (all p > 0.05). While KTxRs underwent pancreatectomy mostly at transplant centers (84.0% vs 58.9%, p=0.011), receipt of perioperative pancreatectomy care at transplant centers did not negatively affect any outcome. Conclusion: KTxR demonstrate similar clinical outcomes with non-KTxR when undergoing pancreatectomy. Prior kidney transplant should not be considered a contraindication to undergoing pancreatic resection.