Outcomes of simultaneous pancreas and kidney transplants based on preemptive transplant compared to those who were on dialysis before transplant – a retrospective study
Corresponding Author
Sandesh Parajuli
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Correspondence
Sandesh Parajuli, 4175 MFCB, 1685 Highland Ave., Madison, WI 53705, USA.
Tel.: +16082650152;
fax: +16082626743;
e-mail: [email protected]
Search for more papers by this authorKurtis J. Swanson
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorRavi Patel
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorBrad C. Astor
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorFahad Aziz
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorNeetika Garg
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorMaha Mohamed
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorTalal Al-Qaoud
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorRobert Redfield
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorArjang Djamali
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorDixon Kaufman
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorJon Odorico
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorDidier A. Mandelbrot
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorCorresponding Author
Sandesh Parajuli
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Correspondence
Sandesh Parajuli, 4175 MFCB, 1685 Highland Ave., Madison, WI 53705, USA.
Tel.: +16082650152;
fax: +16082626743;
e-mail: [email protected]
Search for more papers by this authorKurtis J. Swanson
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorRavi Patel
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorBrad C. Astor
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorFahad Aziz
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorNeetika Garg
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorMaha Mohamed
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorTalal Al-Qaoud
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorRobert Redfield
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorArjang Djamali
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorDixon Kaufman
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorJon Odorico
Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorDidier A. Mandelbrot
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Search for more papers by this authorSummary
Among kidney transplant recipients, the duration of pretransplant dialysis is significantly associated with worse post-transplant outcomes. However, data on the outcomes of preemptive simultaneous pancreas and kidney (SPK) are limited. We analyzed primary SPK recipients transplanted between January 2000 and December 2017. Patients were divided into two groups based on pretransplant dialysis history of preemptive versus non-preemptive. Patient and survival of grafts were outcomes of interest. Of the 644 recipients, 174 (27%) were preemptive and 470 (73%) were not. Most of the baseline characteristics were similar between the groups. In the univariable analysis, the non-preemptive transplant was associated with 54% increased risk for kidney death-censored graft failure (DCGF; HR: 1.54; 95% CI: 1.01–2.35; P = 0.05). There was a 29% increased risk after adjustment for confounding factors (HR: 1.29; 95% CI: 0.83–2.02; P = 0.26), although this association was not statistically significant. Similarly, there was a 16% increased risk of pancreas DCGF in univariable analysis and 1% after adjustment, which was also not statistically significant. When outcomes were based on the duration of pretransplant dialysis, the duration was not associated with either patient survival or survival of either graft in K-M analysis. In SPK recipients, with pretransplant dialysis history, there was a tendency toward inferior graft survival, mainly for the kidney more than the pancreas.
Conflicts of interest
The authors have declared no conflicts of interest.
Supporting Information
| Filename | Description |
|---|---|
| tri13665-sup-0001-FigS1.pdfPDF document, 134.8 KB | Figure S1. Outcomes based on the pre-transplant dialysis: preemptive vs. >12 months. |
| tri13665-sup-0002-FigS2.pdfPDF document, 131.2 KB | Figure S2. Outcomes based on the pre-transplant dialysis: preemptive vs. >24 months. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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