Pancreas Graft Failure Cause by Category

Pancreas graft failure cause for 2000-2004 US DD SPK, PAK and PTA primary transplants varied depending on the time posttransplant and the category (Figure 13). Technical failure (TF) includes thrombosis, infection, pancreatitis, anastomotic leak or bleed leading to removal. TF was the major cause in the first 6 months posttransplant in all categories, >55%; but after 6 months it decreased to 22% SPK, 8% PAK and 31% PTA.  Immunological pancreas graft failure includes acute and chronic rejection recurrence of autoimmune isletitis with selective beta cell destruction. Acute rejection occurred from 7%-25% depending on the time period. It occurred most frequently 7-12 months posttransplant for all recipient categories: SPK, PAK, PTA.  Chronic rejection was reported in 2%-33% as failure cause depending on the time period. For SPK, PAK and PTA it occurred most frequently >12 months posttransplant.  Primary Non-Function (PNF), for purposes of this analysis, included those cases within the first 6 months who were never off insulin posttransplant. PNF represents only 3%-5% of pancreas graft failures depending on the category. Recipients with functioning pancreas grafts will eventually die (DWFG), this being the most desirable outcome providing there is not premature death. DWFG was reported as the cause more frequently in pancreas grafts that failed at 7-12 months or >12 months vs. those  at ≤6 months: 36-45% vs. 20% SPK; 15-32% vs. 12% PAK; 8-16% vs. 7% PTA. 

Figure 13

Previous page / Next page / Index