TY - JOUR
T1 - Risk Factors and Impact of Delayed Graft Function after Pancreas Transplants
AU - Tan, Miguel
AU - Kandaswamy, Raja
AU - Sutherland, David E.R.
AU - Gruessner, Rainer W.
AU - Gruessner, Angelika C.
AU - Humar, Abhinav
PY - 2004/5
Y1 - 2004/5
N2 - Delayed graft function (DGF) occurs after many pancreas transplants (PTx), but is poorly characterized. We studied its incidence, course, and impact in a series of 531 pancreas transplants. Between January 1997 and September 2002, we performed 531 technically successful primary PTx. Of these 531 recipients, 176 (33%) had DGF, defined by their need for exogenous insulin at the time of hospital discharge. The incidence of DGF was roughly equivalent in the three transplant categories: SPK (36%), PAK (32%), and PTA (31%) (p = NS). By 3 months posttransplant, only 19 (3.5%) of all recipients remained on insulin. Only three recipients (0.56%) did not achieve insulin independence. The mean donor age of recipients with DGF was 35.1 years vs. 28.8 years without DGF (p = 0.003). By multivariate analysis, the most significant risk factor for DGF was donor age > 45 years (RR = 4.3, p = 0.0001). For SPK recipients with DGF, graft survival was 87% at 1 year and 82% at 3 years posttransplant; without DGF, 94% at 1 year and 87% at 3 years (p = 0.07). For PAK and PTA recipients, no difference was noted. Acute rejection rates were somewhat higher in recipients with DGF, but this did not reach statistical significance.
AB - Delayed graft function (DGF) occurs after many pancreas transplants (PTx), but is poorly characterized. We studied its incidence, course, and impact in a series of 531 pancreas transplants. Between January 1997 and September 2002, we performed 531 technically successful primary PTx. Of these 531 recipients, 176 (33%) had DGF, defined by their need for exogenous insulin at the time of hospital discharge. The incidence of DGF was roughly equivalent in the three transplant categories: SPK (36%), PAK (32%), and PTA (31%) (p = NS). By 3 months posttransplant, only 19 (3.5%) of all recipients remained on insulin. Only three recipients (0.56%) did not achieve insulin independence. The mean donor age of recipients with DGF was 35.1 years vs. 28.8 years without DGF (p = 0.003). By multivariate analysis, the most significant risk factor for DGF was donor age > 45 years (RR = 4.3, p = 0.0001). For SPK recipients with DGF, graft survival was 87% at 1 year and 82% at 3 years posttransplant; without DGF, 94% at 1 year and 87% at 3 years (p = 0.07). For PAK and PTA recipients, no difference was noted. Acute rejection rates were somewhat higher in recipients with DGF, but this did not reach statistical significance.
KW - Delayed graft function
KW - Pancreas transplant
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=2442445414&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=2442445414&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2004.00408.x
DO - 10.1111/j.1600-6143.2004.00408.x
M3 - Article
C2 - 15084171
AN - SCOPUS:2442445414
SN - 1600-6135
VL - 4
SP - 758
EP - 762
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 5
ER -