Impact of Pancreatic Allograft Function on 1-Year Survival Rates After Simultaneous Pancreatic-Renal Transplant

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Data
2008-12-01
Autores
Rangel, Erika Bevilaqua [UNIFESP]
Melaragno, Cláudio Santiago [UNIFESP]
Gonzalez, Adriano Miziara [UNIFESP]
Linhares, Marcelo Moura [UNIFESP]
Sá, João Roberto de [UNIFESP]
Salzedas, Alcides [UNIFESP]
Pestana, Jose Osmar Medina [UNIFESP]
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Objectives: Simultaneous pancreatic-renal transplant is an effective treatment for insulin-dependent patients with chronic renal failure. We sought to identify the main influences on pancreatic and patient survival rates after simultaneous pancreas-kidney transplants.Patients and Methods: The 1-year patient and pancreas survival rates of 150 patients who had undergone simultaneous pancreas-kidney transplant were analyzed by the Cox proportional hazards regression model and the Kaplan-Meier method. Uni- and multivariate analyses were performed in terms of transplant-, recipient-, and donor-related risk factors.Results: At 1 year, patient and pancreatic allograft survival rates were 82% and 76.7%, respectively. Delayed graft function in the kidney (P = .001, HR 5.41), acute kidney rejection (P = .016, HR 3.36), and intra-abdominal infection (P < .0001, HR 4.15) were the main factors related to 1-year patient survival. Pancreatic allograft survival at 1 year was related to intra-abdominal infection (P < .0001, OR 12.83), vascular thrombosis (P = .002, OR 40.55), acute kidney rejection (P = .027, OR 3.06), donor sodium greater than 155 mEq/L (P = .02, OR 3.27), and dopamine administration exceeding 7.6 mu g/kg/min (P = .046, OR 2.85).Conclusions: Delayed kidney allograft function and intra-abdominal infection had an important effect on both patient and pancreatic allograft survival rates.
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Experimental And Clinical Transplantation. Ankara: Baskent Univ, v. 6, n. 4, p. 301-306, 2008.
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