Historical era: SPK, USA PAK, PTA Graft Survival (1-year, 3-year, 5-year)

Pancreas graft survival rates (GSRs) have shown consistent improvement over time.

1-year graft survival rates

For the 1999-2002 US cadaver primary pancreas transplant cases available for analysis, 1-year pancreas GSRs are almost equal across categories. By era, SPK 1-year GSRs improved significantly (p=0.0001) from 76% bladder drained (BD) (n=1,846) and 61% enteric drained (ED) (n=62) to 84% BD SPK (n=711) and 84% ED SPK (n=2,360) for 1998-2001. PAK improved from 56% for 1987-92 (n=133) to 78% 1999-2001 (n=748 (p=0.0001). PTA improved from 56% in 1987-92 (n=102) to 78% in 1998-2001 (n=329) (p<0.0001) (Figure 9a). SPK kidney 1-year GSRs improved from 83% to 92%, at least equal to diabetic recipient kidney transplants alone as reported to UNOS. For PAK, death censored kidney GSRs at 1-year were at least 92% across all eras. For PTA, kidney after pancreas (KAP) transplants are dependent on preexisting nephropathy and/or calcineurin-inhibitor induced nephrotoxicity; the rate at 1-year across eras ranged from 0% to 2%.

Figure 9a

3-year and 5-year graft survival rates

The pancreas GSRs at 3-year and 5-year are also higher than in earlier eras. This trend in continual GSR improvement over time in long-term outcome is a positive indicator for 1999-2002 cases in all categories, where only early outcome analysis can be done. GSR improvement at 3-years was from about 70% SPK and <40% PAK and PTA in 1988-91 to 75% SPK and 50% PAK and PTA in 1994-97; for 1998-99 cases, 3-year GSRs were SPK 78%, PAK 68% and PTA 67% (Figure 9b). GSR at 5-years improved from about 60% SPK and 20%-30% PAK and PTA in 1988-91 to over 70% SPK and 45% PAK and PTA in 1996-97 (Figure 9c). PAK death censored kidney GSR at 5 years was 80% for 1993-95 recipients. PTA followed by KAP incidence at 5 years was 15% for 1993-95 recipients.

Figure 9b

Figure 9c