Steroid maintenance is associated with an increased risk of infections but has no effect on patient and graft survival in pancreas transplantation: A retrospective review of the UNOS database

Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Leo I AmoduJorge Ortiz

Abstract

The appropriateness of steroid maintenance in pancreas transplantation is unproven. The current literature is insufficient due to small numbers, short follow-up and sparse data. Data from the UNOS database on adults ≥18 years old, who received pancreas and kidney-pancreas transplants between January 1996 and March 2014 were analyzed (n = 27,077). Two groups were evaluated: (a) Steroids Induction only (n = 4391) and (b) Steroid maintenance (n = 22,686). One-, 3-, 5-, 10-, and 15-year unadjusted patient and graft survival rates were compared. A Cox proportional hazards model was used to determine what patient factors were associated with these outcomes. There were differences in patient survival at 1 and 3 years and in graft survival at 3 and 5 years. There was a higher rate of infectious complications in the maintenance group, but after controlling for several recipient factors, whether a patient received steroid maintenance or not, was not significantly associated with the risk of death or graft failure. The use of maintenance steroids is significantly associated with an increased risk of infectious complications, but no difference in patient death or graft failure after controlling for multiple recipient factors. There is also...Continue Reading

References

Jul 13, 2001·Infectious Disease Clinics of North America·N C KleinB A Cunha
Jan 24, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·D B KaufmanM A Parker
Oct 16, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Davide MineoCamillo Ricordi
May 16, 2013·Transplant International : Official Journal of the European Society for Organ Transplantation·Silke V NiederhausJon S Odorico
Jan 6, 2015·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·C M ArceW C Winkelmayer
Jan 8, 2015·Current Opinion in Organ Transplantation·Robert R RedfieldJon S Odorico

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Citations

Nov 21, 2015·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Yoko MatsudaTomio Arai
Jul 14, 2017·Clinical Diabetes and Endocrinology·Marcio W Lauria, Antonio Ribeiro-Oliveira

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