USA Pancreas Graft Immunological Loss

For technically successful (TS) DWFG censored primary cadaver US pancreas transplants 1999-2002, the rates for pancreas immunological loss (rejection or recurrence of autoimmune disease) decreased across all categories. SPK rates were only 2% at 1-year in both BD and ED cases (Figure 19a). The overall SPK rate has decreased steadily from 6% in the 1987-92 era to 2% in the 1999-2002 era (p=0.0001). Similar results were noted for BD vs. ED in both PAK and PTA categories (Figure 19b and 19c). In fact, there was no significant difference for BD vs. ED PAK or PTA immunological pancreas graft failure rates for the 1999-2002 cases: for PAK, the rate was 5%; for PTA, the rate was 7%. As noted earlier in the technical failure analyses, some technical graft failures may actually be thrombosis secondary to rejection, especially in the ED solitary transplants where urine amylase cannot be used to monitor for decrease in graft function. Historically, overall PAK and PTA immunological graft loss rates have dramatically decreased: for PAK, from 23% in the 1987-92 era to 2% in the 1999-2002 era (p=0.0001); for PTA, from 28% in the 1987-92 era to 7% in the 1999-2002 era (p=0.0001).

Figure 19a

Figure 19b

Figure 19c