Influence of Donor and Recipient Ages in Survival of Simultaneous Pancreas-Kidney Transplantation

Arenas-Bonilla, A.J.; Campos-Hernández, J.P.; Carrasco‐Valiente, Julia; Márquez-López, F.J.; Ruiz-García, J.; Sánchez, Á.; Salamanca-Bustos, J.J.; Regueiro-López, Juan Carlos; Navarro-Cabello, M.D.; Requena-Tapia, M.J.

doi:10.1016/j.transproceed.2016.07.046

Cited by 13 publications

(14 citation statements)

References 9 publications

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“…While there was a survival benefit for older recipients to undergo transplantation rather than remaining on the waiting list, older donors were associated with higher graft failure and mortality rates when allocated to both younger and older recipients, with outcomes poorest in the older recipient group. Similar conclusions had been drawn in other published analyses . Our analysis found 40% of recipients who died within the first year post‐transplant and had suffered the insult of early pancreas or kidney graft failure.…”

Section: Discussionsupporting

confidence: 91%

An analysis of the association between older recipient age and outcomes after whole‐organ pancreas transplantation – a single‐centre, retrospective study

Mittal

Smilevska²,

Franklin

et al. 2020

Transpl Int

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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.

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Section: Discussionsupporting

confidence: 91%

An analysis of the association between older recipient age and outcomes after whole‐organ pancreas transplantation – a single‐centre, retrospective study

Mittal

Smilevska²,

Franklin

et al. 2020

Transpl Int

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“…The signi cant differences in overall, graft and kidney survival found in the Kaplan-Meier analysis were mainly related to donors' age, which has been con rmed as a risk factor for death [20,21]. However, only a small difference between the smoking and non-smoking donors was found when the donors' age was analyzed by subgroups.…”

Section: Discussionmentioning

confidence: 87%

Influence of donors’ cigarette smoking on recipients’ postoperative survival and complications after simultaneous pancreas-kidney transplantation

Gu¹,

Zhou²,

Xiang³

et al. 2020

Preprint

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“…Donor age in our cohort did not negatively impact patient survival, but recipients of older donor organs had a significantly impaired graft survival compared to recipients of younger organs. Kayler et al demonstrated that recipients of old donor organs had a similar adjusted relative mortality risk as patients who remained on the waitlist and subsequently got a SPK of a young donor if transplanted within 604 days waiting time [13] Arenas‐Bonilla et al [23] divided their cohort of 115 SPK recipients into four age categories based on recipient and donor age (cut‐off 40 years) and did not find any differences in patient, pancreas or kidney graft survival. Yet, because young to old tended to have a superior survival compared to old‐to‐old, they concluded that old recipients benefit from younger donor organs.…”

Section: Discussionmentioning

confidence: 99%

Recipient age and outcome after pancreas transplantation: a retrospective dual‐center analysis

Messner

Leemkuil

et al. 2021

Transpl Int

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With a later onset of diabetes complications and thus increasing age of transplant candidates, many centers have extended upper age limits for pancreas transplantation. This study investigates the effect of recipient and donor age on outcomes after pancreas transplantation.We retrospectively analyzed 565 pancreas transplants performed at two Eurotransplant centers. The cohort was split at a recipient and donor age of 50 and 40 years, respectively. Median recipient age in old patients (≥50 years; 27.2%) was 54 years and 40 years in young patients (<50 years). Compared to young recipients, old recipients had an inferior patient survival rate (≥50: 5yr, 82.8%; 10yr, 65.6%; <50: 5yr, 93.3%; 10yr, 82.0%; P < 0.0001). Old recipients demonstrated comparable death‐censored pancreas (≥50: 1yr, 80.6%; 5yr, 70.2%; <50: 1yr, 87.3%; 5yr, 77.8%; P = 0.35) and kidney graft survival (≥50: 1yr, 97.4%; 5yr, 90.6%; <50: 1yr, 97.8%; 5yr, 90.2%; P = 0.53) compared to young recipients. Besides a lower rate of kidney rejection, similar relative risks for postoperative complications were detected in old and young patients. This study shows that despite an increased mortality in old recipients, excellent graft survival can be achieved similar to that of young patients. Age alone should not exclude patients from receiving a pancreas transplant.

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Influence of Donor and Recipient Ages in Survival of Simultaneous Pancreas-Kidney Transplantation

Cited by 13 publications

References 9 publications

An analysis of the association between older recipient age and outcomes after whole‐organ pancreas transplantation – a single‐centre, retrospective study

An analysis of the association between older recipient age and outcomes after whole‐organ pancreas transplantation – a single‐centre, retrospective study

Influence of donors’ cigarette smoking on recipients’ postoperative survival and complications after simultaneous pancreas-kidney transplantation

Recipient age and outcome after pancreas transplantation: a retrospective dual‐center analysis

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