Pancreas retransplantation: a second chance for diabetic patients?

Abstract:

BACKGROUND:If pancreas transplantation is a validated alternative for type 1 diabetic patients with end-stage renal disease, the management of patients who have lost their primary graft is poorly defined. This study aims at evaluating pancreas retransplantation outcome. METHODS:Between 1976 and 2008, 569 pancreas transplantations were performed in Lyon and Geneva, including 37 second transplantations. Second graft survival was compared with primary graft survival of the same patients and the whole population. Predictive factors of second graft survival were sought. Patient survival and impact on kidney graft function and survival were evaluated. RESULTS:Second pancreas survival of the 17 patients transplanted from 1995 was close to primary graft survival of the whole population (71% vs. 79% at 1 year and 59% vs. 69% at 5 years; P=0.5075) and significantly better than their first pancreas survival (71% vs. 29% at 1 year and 59% vs. 7% at 5 years; P=0.0008) regardless of the cause of first pancreas loss. The same results were observed with all 37 retransplantations. Survival of second simultaneous pancreas and kidney transplantations was better than survival of second pancreas after kidney. Patient survival was excellent (89% at 5 years). Pancreas retransplantation had no impact on kidney graft function and survival (100% at 5 years). CONCLUSION:Pancreas retransplantation is a safe procedure with acceptable graft survival that should be proposed to diabetic patients who have lost their primary graft.

journal_name

Transplantation

journal_title

Transplantation

authors

Buron F,Thaunat O,Demuylder-Mischler S,Badet L,Brunet M,Ber CE,Thivolet C,Martin X,Berney T,Morelon E

doi

10.1097/TP.0b013e318271d795

subject

Has Abstract

pub_date

2013-01-27 00:00:00

pages

347-52

issue

2

eissn

0041-1337

issn

1534-6080

journal_volume

95

pub_type

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