Summary
Older people are increasingly being referred for consideration for pancreas transplantation (PT). We investigated the outcomes after PT in our older recipient cohort. A prospectively maintained database was interrogated. The cohort was analysed for associations between outcome and older recipient age. A total of 444 transplants were performed in patients aged 23–54 years and 83 transplants in patients aged 55–67 years. There was no difference in death‐censored pancreas or kidney graft survival between the groups. Patient death was associated with older recipient age (HR 1.63 per 10‐year increase). In multivariate Cox regression, risk of mortality was also associated with post‐transplant myocardial infarction (HR 7.25, P = 0.006), pancreas failure (HR 1.91, P = 0.003) and kidney failure (HR 3.55, P < 0.001). About 40% of recipients who died in the first year post‐transplant suffered early graft loss. Those alive at a year post‐transplant had inferior survival if they had lost their kidney graft (P < 0.001). Mortality is higher in older patients and is strongly associated with pancreas and kidney graft failure. This suggests that pancreas transplantation is feasible in older recipients, and careful selection of donor organs is important to optimize survival.
percentage and kinetic growth rate (KGR) as percentage/ week were used to assess the increase of the liver volume.Results: In this study,142 patients were enrolled. Sequential pre-and post-CT-scans were available for 53 patients (32 for CRLM, 21 for pCCA). Liver segment II and III volumes increased significantly after PVE in both groups (P < 0.001). pCCA patients with cholangitis (n=4) had an almost blunted DH (P = 0.042). DH and KGR did not differ (P = 0.719 and P = 0.968, respectively) between drained and undrained pCCA patients. Higher initial bilirubin level before biliary drainage was correlated with less PVEinduced DH (r=-0.727, P = 0.007). The bilirubin level and bile duct diameter before PVE was not associated with DH and KGR. Conclusion: Initial bilirubin levels before biliary drainage were negatively correlated with PVE-induced liver hypertrophy in patients with pCCA. Biliary duct diameter and bilirubin level right before PVE seems less of influence on PVE induced hypertrophy.
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