Outcome Effects: Recipient Age, Diabetes Type, Venous Vascular Management for USA Cases

Effect of Recipient Age on Outcome by Era

Pancreas transplant outcome has improved over time in recipients >45 years of age and the proportion of these recipients has increased from 4% in 1988 to 26% in 2000.

For SPK recipients, patient survival improved from 76% in the 1987-90 era to 93% in the 1998-2000 era and pancreas graft survival improved from 62% in the 1987-90 era to 78% in the 1998-2000 era.

In the solitary groups, there were few recipients >45 in the early eras. However, in the PAK group, patient survival change, while not statistically significant, went from 78% in the 1987-90 era to 91% in both the 1996-97 and 1998-2000 eras. PAK pancreas graft survival did significantly improve from 44% in the 1987-90 era to 73% in the 1998-2000 era. For PTAs, patient survival has been 100% for the last three eras and has always been at least always 80%. PTA graft survival has dramatically improved from 54% in the 1991-93 era to 87% in the 1998-2000 era.

Effect of Diabetes Type on SPK Outcome for 1996-2000 cases

Of 1996-2000 cadaver SPK recipients (n=3494), only 4% were classified as type 2 (type 1 n=3323, type 2 n=157). Age ranges were 16-69 (mean 38+7 years) for type 1 and 31-59 (mean 44+7 years) for type 2, (P=0.0001). Neither patient survival rates nor pancreas graft survival rates had statistically significant differences between type 1 and type 2 cases. For type 1, patient survival at 1 year was 95% and pancreas graft survival was 73%; for type 2, rates were 91% and 71% respectively.

Effect of Venous Vascular Management on SPK Outcome for 1996-2000 cases

Over half the SPK transplants (55%) were done using enteric drainage (ED). Of the cases with complete records for analysis of the effect on outcome of systemic versus portal venous vascular management (n=1920), about 21% (n=411) used portal versus systemic (n=1509). Pancreas graft survival rates were no different for portal versus systemic ED SPK transplants: 83% at 1 year.