Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation · 2026
Pancreas Retransplant After Simultaneous Pancreas-Kidney Transplant Yields Graft and Patient Survival Comparable to Primary Transplantation in the Post-2018 Era.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Khan Sohail, Toro Deric, Gonzalez Sophia, Zuluaga Dayanna, McAfee Gavin, Faddoul Giovanni, Koizumi Naoru, Li Meng-Hao, Cohen Hannah, Ortiz Jorge
Аннотация
OBJECTIVES: Historical registry analyses have reported inferior outcomes and higher early technical failure rates following pancreas-only retransplant after simultaneous pancreas-kidney transplantation, contributing to cautious utilization. Implementation of standardized pancreas graft failure definitions permits contemporary national reassessment of these outcomes.
MATERIALS AND METHODS: National registry data were extracted to evaluate 7966 adult recipients undergoing primary simultaneous pancreas-kidney transplantation (n = 7895) or pancreas-only retransplant with preserved kidney allograft function (n = 71) between February 2018 and December 2024. Multivariable regression and Cox proportional hazards models assessed pancreas graft failure and mortality.
RESULTS: Among 7966 adult simultaneous pancreas-kidney transplant recipients (7895 primary; 71 pancreas-only retransplant) from 2018 through 2024, retransplant recipients were older (71.8% vs 54.8% aged 40-59 years; P = .007), more frequently White (70.4% vs 46.9%; P = .003), had longer waiting times (627.9 vs 321.5 days; P < .001), longer pancreas preservation time (12.6 vs 10.4 hours; P < .001), and were more often transplanted at high-volume centers (69.0% vs 47.9% at centers with >100 simultaneous pancreas-kidney transplants; P < .001). Retransplant was not independently associated with pancreas graft failure or mortality at 1 year or 3 years. In Cox models, retransplant was not associated with pancreas graft failure (hazard ratio 0.84; P = .683) or mortality (hazard ratio 1.19; P = .544). Increasing recipient age and national sharing independently predicted mortality.
CONCLUSIONS: In the contemporary era of standardized pancreas graft failure reporting, pancreas retransplant with preserved kidney function achieves graft and patient survival comparable to primary simultaneous pancreas-kidney transplant nationally. Although retransplant recipients represent a small and highly selected cohort, these population-level data reinforce selective retransplant consideration at experienced centers following pancreas allograft failure.
MATERIALS AND METHODS: National registry data were extracted to evaluate 7966 adult recipients undergoing primary simultaneous pancreas-kidney transplantation (n = 7895) or pancreas-only retransplant with preserved kidney allograft function (n = 71) between February 2018 and December 2024. Multivariable regression and Cox proportional hazards models assessed pancreas graft failure and mortality.
RESULTS: Among 7966 adult simultaneous pancreas-kidney transplant recipients (7895 primary; 71 pancreas-only retransplant) from 2018 through 2024, retransplant recipients were older (71.8% vs 54.8% aged 40-59 years; P = .007), more frequently White (70.4% vs 46.9%; P = .003), had longer waiting times (627.9 vs 321.5 days; P < .001), longer pancreas preservation time (12.6 vs 10.4 hours; P < .001), and were more often transplanted at high-volume centers (69.0% vs 47.9% at centers with >100 simultaneous pancreas-kidney transplants; P < .001). Retransplant was not independently associated with pancreas graft failure or mortality at 1 year or 3 years. In Cox models, retransplant was not associated with pancreas graft failure (hazard ratio 0.84; P = .683) or mortality (hazard ratio 1.19; P = .544). Increasing recipient age and national sharing independently predicted mortality.
CONCLUSIONS: In the contemporary era of standardized pancreas graft failure reporting, pancreas retransplant with preserved kidney function achieves graft and patient survival comparable to primary simultaneous pancreas-kidney transplant nationally. Although retransplant recipients represent a small and highly selected cohort, these population-level data reinforce selective retransplant consideration at experienced centers following pancreas allograft failure.