Abstract
Previous studies have questioned the safety of vascularized pancreas transplantation (PTX), particularly because diabetes is an independent risk factor for coronary artery disease and cardiac death. A retrospective analysis of the timing and causes of death after PTX was performed. From April 1989 through December 1995, 196 PTXs were performed in 186 diabetic patients including 134 simultaneous kidney-PTXs, 59 solitary PTXs, and 3 combined liver-PTXs. All patients underwent whole organ PTX with bladder drainage, received triple or quadruple immunosuppression, and had a minimum follow-up of 1 year (mean 3.8 years). A total of 22 patients (12%) died at a mean of 19 months after PTX. Infection was the most common cause of early death, whereas the majority of late deaths were due to cardiac causes. In the 8 deaths caused by infection, 6 were associated with operative complications, but only 2 received excessive immunosuppression for rejection. In the 10 cardiac deaths, 6 patients were older than 40 years at the time of PTX and 4 had experienced pancreas graft loss before death. Four-year actuarial patient survival was 92% after simultaneous kidney-PTX and 87% after solitary PTX. In this series, the mortality rate after PTX was 12%,...Continue Reading
References
Dec 24, 1992·The New England Journal of Medicine·R P Robertson
Jul 1, 1990·Diabetes·X NavarroD E Sutherland
Jan 1, 1995·Annual Review of Medicine·R J StrattaK Cushing
Jun 15, 1994·Transplantation·R W GruessnerD E Sutherland
Jun 10, 1993·The New England Journal of Medicine·D M Nathan
May 1, 1993·Transplantation·R J StrattaA N Langnas
Dec 23, 1995·Lancet·C L ManskeW Thomas
Oct 1, 1996·Archives of Family Medicine·G C Groggel
May 15, 1997·Transplantation·E J SchweitzerS T Bartlett
Aug 1, 1997·Journal of the American College of Surgeons·R W GruessnerA C Gruessner
Apr 16, 1998·Diabetes Care
Jul 10, 1998·Disease-a-month : DM·S M Kobrin
Citations
Aug 13, 1999·Diabetic Medicine : a Journal of the British Diabetic Association·S A WhiteN J London
Oct 17, 2001·Surgery·J A SchulakA Bohnengel
Jun 9, 2001·Transplantation·T I SteinmanUNKNOWN Clinical Practice Committee, American Society of Transplantation
Nov 30, 2005·Transplantation·Adriano M GonzalezTarcisio Trivino
Dec 22, 2005·Diabetes, Obesity & Metabolism·Sulaiman A Nanji, A M James Shapiro
May 26, 2001·Postgraduate Medical Journal·S A WhiteM L Nicholson
Jun 22, 2005·Treatments in Endocrinology·Daniel M RidgwayRachel M Kimber
Dec 21, 2012·Current Opinion in Organ Transplantation·Kathrin EllerAlexander R Rosenkranz
May 23, 2009·Transplantation Proceedings·I FontanaU Valente
Apr 1, 2008·Transplantation Proceedings·R P SinghR J Stratta
Sep 27, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Jeffrey RogersP R Rajagopalan
May 2, 2006·Transplantation Proceedings·G WoesteW O Bechstein
Nov 22, 2005·Transplantation Proceedings·G MichalakW Rowiñski
Apr 26, 2005·Transplantation Proceedings·S EschertzhuberC Hoermann
Aug 16, 2011·Transplantation Proceedings·M J Pérez-SáezP Aljama
Mar 17, 2001·Diabetic Medicine : a Journal of the British Diabetic Association·S A WhiteM L Nicholson
Mar 30, 2002·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Wolfgang MoritzMarkus Weber
May 26, 2009·Lancet·Steve A WhiteDavid E R Sutherland