Recipient Age Effect on Pancreas Transplant Outcome

Primary DD recipient age groups: 15-29 (n=435) 9%, including a <22 subgroup (n=18) 0.3%; 30-44 (n=3,271) 59%; 45-59 (n=1,774) 32%; 50-59 (n=819) 13%; >60 (n=67) 1%.  Recipients ≥45 years: SPK 32%; PAK 36%; PTA 34%; (p=.001). The youngest recipient was 15 years and received a PTA. Patient survival rates were high in all age groups across categories: 94-97%. For patient survival, it might be expected that rates would be lower with increasing age.  This was the case only for PAK in the univariate analysis (Figure 18a). In the multivariate analysis (see Table  1 above), both SPK and PAK recipients ≥45 years had a significantly higher HR for survival compared to the 30-44 group. There was no definite relation for PTA in either univariate or multivariate analyses. Younger recipients did not show increased risk. For pancreas graft survival rates at 1 year (Figure 18b), age had little effect for SPK: 84-86% with highest GSR in the ≥45 group at 86.4%; kidney GSR was 93% for 30-44 years with slightly lower in younger and older groups (p>0.18). But there was significant effect in PAK and PTA. In these categories, PAK recipients 30-44 years had the highest GSR at 1 year, 81%; PTA recipients <30 years had the lowest at 1 year: 56%.  This difference was due to rejection loss rates (Figure 18c): 2-11%, decreasing with increasing age in all categories except PTA <30 years old where the rejection loss rate was 30%. This was confirmed by multivariate analysis (Table 6).

Figure 18a

Figure 18b

Figure 18c

Table 6.    Cox – regression for immunological pancreas graft failure (technically successful US DD primary pancreas transplants 1/1/2000 – 6/2004)

Recipient age at transplant has significantly increased over time (Figure 19), from a mean of 34.8±6.7 years in 1988-89 to 41.1±8.3 years.. In 2002-03, recipients over the age of 50 were 15% PTA (n=34), 14% PAK (n=98), 12% SPK (n=224).

Figure 19

Previous page / Next page / Index