Long-term outcomes of pancreas after kidney transplantation in small centers: Is it justified?

M. R. Laftavi, O. Pankewycz, A. Gruessner, Murray Brian, R. Kohli, L. Feng, M. Said, R. Sharma, S. Patel

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background. Currently, the long-term advantages of having a pancreas transplantation (PT) are debated, particularly in patients receiving pancreas after kidney (PAK) allografts. The United Network for Organ Sharing (UNOS) requires that a transplant center perform a minimum number of PT per year to remain an active PT center. The long-term outcomes and challenges of PAK in small pancreas transplant centers are not well studied. Methods. In this retrospective analysis, we report short- and long-term outcomes in a small center performing 2-9 PT annually. Results. Forty-eight PT (25 simultaneous pancreas and kidney transplantation [SPK], 23 PAK) were performed in our center. Donor and recipient demographics were similar in both groups. All suitable local donors were used for SPK. All organs for PAK transplantation were imported from other UNOS regions. Mean follow-up was 61 ± 46 and 74 ± 46 months for SPK and PAK, respectively. Patient and graft survival rates were similar in SPK and PAK groups and better than the reported national average. Four patients (11%) died (1 due to trauma, 1 brain lymphoma, 1 ruptured aneurysm; and 1 unknown cause). Two patients (4%; 1 SPK, 1 PAK) lost their grafts because of thrombosis on postoperative days 3 and 5 in 2002. No graft thrombosis occurred since 2002. Seven patients (15%) required reoperation (4 for bleeding, 2 anastomotic leaks, 1 small bowel perforation). Two patients (4%) developed post-transplantation lymphoproliferative disease. Five patients (11%) experienced cytomegalovirus antigenemia which responded well to antiviral therapy. Conclusions. Compared with outcomes for diabetic patients on dialysis, current SPK and PAK short- and long-term results are favorable even in a small PT center. Therefore, unless there is a contraindication, PT should be offered to all type 1 diabetic patients with end-stage renal disease at the time of kidney transplantation or afterward.

Original languageEnglish (US)
Pages (from-to)1920-1923
Number of pages4
JournalTransplantation proceedings
Issue number6
StatePublished - 2014

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation


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