Of the factors impacting patient survival, graft function is one of the most prominent (Figure 7).
Figure 7
Patient survival rates at 1 year for US 2000-2004 SPK and PAK DD primary transplants were 97% SPK and PAK functioning grafts vs. 72% SPK and 88% PAK failed grafts. When only one of the grafts failed, kidney graft loss had more consequence than did pancreas graft loss, as shown in the multivariate Cox-regression with graft failure as time-dependent variables (Table 1). The hazard ratio (HR) of a failed kidney graft was 14.99 in SPK and 9.17 in PAK (p<0.0001) and for a failed pancreas 3.51 (p<0.0001) for SPK and 4.17 for PAK (P<0.0001). The computed hazard ratio for the case that both organs failed is over 40.00 for both categories.
Table 1. Cox–regression for patient death (US DD primary pancreas transplants 1/1/2000 – 6/2004)
| Variables |
SPK |
PAK |
PTA |
| |
p RR* |
p RR* |
p RR* |
| Large vs. Small Centers |
0.82 - |
0.45 - |
0.78 - |
| BD vs. ED |
0.0008 1.57 |
0.39 0.64 |
0.23 |
Recipient Age
15-29 yrs vs. 30-44 yrs
≥45 yrs vs. 30-44 yrs |
0.75
0.004 1.59 |
0.51
0.003 2.53 |
0.83
0.21 |
| Yrs Diabetes [25 yrs] |
0.33 |
0.51 - |
0.50 - |
| Male vs. Female Rec. |
0.34 - |
0.07 0.59 |
0.91 - |
| Pancreas Graft Loss |
0.0001 3.51 |
0.0001 4.17 |
0.90 |
| Kidney Graft Loss |
0.0001 14.99 |
0.0001 9.17 |
|
| LD vs. DD Kidney |
0.31 - |
0.12 0.63 |
- - |
| SIR vs. none |
0.33 - |
0.002 0.56 |
0.96 - |
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