Effect of Recipient Age on USA Primary Pancreas Transplant 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 9% in 1987-92 to 29% in 2001-03 (p=0.0001). Outcomes by years are grouped into eras (Figure 13a). Primary DD 1-year patient survival by recipient age is illustrated in Figures 13b (>45) and 13c (<45); primary pancreas graft survival by recipient age in Figures 13d and 13e.

Figure 13a

Figure 13b

Figure 13c

For SPK recipients, 1-year patient survival improved from 87% in the 1987-92 era to 93% in the 2001-03 era (p<0.003) and pancreas graft survival improved from 75% in the 1987-92 era to 85% in the 2001-03 era (p=0.002). Kidney GSRs were 81% and 90% respectively (p<0.0005). In the 2001-03 era, patient survival and pancreas graft survival were nearly equal in recipients >45 years and younger recipients: a difference of only 2% and 1% respectively.

In the solitary groups, there were few recipients >45 in the early eras.  In the PAK group, 1-year patient survival changed from 73% in the 1987-92 era to 93% in the 2001-03 era (p=0.07). PAK pancreas 1-year graft survival dramatically improved from 42% in the 1987-92 era to 76% in the 2001-03 era (p=0.02). Again, in the 2001-03 era PAK older and younger recipients had nearly equal survival rates for patient and pancreas graft: a difference of 2% and 1% respectively.  For PTA, 1-year patient survival has always been at least 80%; for the 2001-03 era it was 98%.  PTA 1-year graft survival has markedly improved from 56% in the 1987-92 era to 75% in the 2000-03 era (p=<0.002).  As with SPK and PAK, in the 2001-03 era PTA patient and pancreas graft survival rates for age >45 years were nearly equivalent to younger recipients: a difference of only 1% for each.

Figure 13d

Figure 13e

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