Risk analysis for deterioration of renal function after pancreas alone transplant.

Journal article

The risk of progression to renal replacement after pancreas transplant alone (PTA) is a concern in patients with pre-transplant estimated glomerular filtration rate (eGFR) < 70 mL/min/1.73 m(2). This is a retrospective, single-center risk analysis of potential factors affecting renal function after PTA. Twenty-four patients, transplanted over a three-yr period, with functioning pancreatic grafts at the study's end point were included. High tacrolimus levels (> 12 mg/dL) at six months post-transplant was the only independent risk factor identifying a substantial decline in native renal function by Cox regression analysis (HR = 14.300, CI = 1.271-160.907, p = 0.031). The presence of severe pre-transplant proteinuria (urine Pr/Cr ≥ 100 mg/mmol) marginally failed to reach significance (p = 0.056). Low eGFR levels alone (≤ 45 and ≤ 40 mL/min/1.73 m(2)) at the time of transplant did not correlate with substantial decline in renal function. Our data suggest that PTA is a justifiable therapy for patients with hypoglycemia unawareness or other life-threatening diabetic complications, even in those with borderline renal function, provided that they do not suffer from severe proteinuria and appropriate monitoring and tailoring of immunosuppression is ensured.

Authors: Chatzizacharias, N; Vaidya, A; Sinha, S; Sharples, E; Smith, R

• Publication status: Published
• Journal: Clinical transplantation
• Volume: 26
• Issue: 3
• Pages: 387-392
• Publication date: 2012-01-01
• DOI: 10.1111/j.1399-0012.2011.01534.x
• EISSN: 1399-0012
• ISSN: 0902-0063
• Language: English
• Keywords: Pancreas Transplantation; Humans; Retrospective Studies; Glomerular Filtration Rate; Female; Risk Assessment; Prognosis; Survival Rate; Male; Renal Insufficiency; Adult; Follow-Up Studies