Macrovascular disease after simultaneous pancreas and kidney transplantation

Clinical Transplantation
Gunnela NordénGudrun Nyberg

Abstract

The objective of this study was to evaluate the outcome of simultaneous pancreas and kidney transplantation (SPK) with focus on cardiovascular mortality and morbidity in relation to graft function. From January 1985 through 1999, 87 SPK were performed in the unit. Sixty recipients were males, median age at diabetes onset 13 yr (1-40) and age at transplantation 39 yr (29-54). No case was lost to follow-up. Morbidity and mortality during median 8 yr of follow-up (range 1-15 yr) were recorded. Major macrovascular disease (MVD) was defined as myocardial infarction or sudden death (AMI), stroke or peripheral gangrene requiring amputation of leg, foot or fingers. At the evaluation, 26 of 87 patients (30%) had died, 19 after loss of the pancreas graft and 20 after loss of the kidney. MVD was the dominant cause of death. Non-lethal MVD had previously been recorded in 62%. Of the 61 patients alive, 22 had lost their pancreas graft and 12 the concomitant kidney. MVD had occurred in 32%. Whereas 89% of the concomitant kidneys functioned when the pancreas graft did so, only 37% of the kidneys functioned if the pancreas had been lost, p < 0.0001. The mortality rate was significantly higher among patients who lost both grafts (16/26) than in...Continue Reading

References

Sep 2, 1998·Transplantation Proceedings·D E SutherlandR W Gruessner
Aug 3, 1999·Transplant International : Official Journal of the European Society for Organ Transplantation·J CarlströmG Nyberg
Aug 13, 1999·Diabetic Medicine : a Journal of the British Diabetic Association·S A WhiteN J London
Apr 17, 2001·Annals of Surgery·D E SutherlandJ S Najarian
May 10, 2001·World Journal of Surgery·D E SutherlandA C Gruessner
Oct 25, 2001·Journal of the American Society of Nephrology : JASN·Bryan N BeckerHans W Sollinger
Mar 30, 2002·Transplantation·Jennifer L LarsenJohn Leone

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