Reported isolated pancreas rejection is associated with poor kidney outcomes in recipients of a simultaneous pancreas kidney transplant

Bruce Kaplan, Patricia West-Thielke, Heather Herren, John Gill, Greg A. Knoll, Jose Oberholzer, Howard Sankary, Enrico Benedetti

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

BACKGROUND.: We hypothesized that many reported and presumed isolated pancreas acute rejection episodes in simultaneous pancreas kidney patients may in fact be missed concordant kidney acute rejection episodes. METHODS.: To test this hypothesis, we undertook an analysis of the Organ Procurement and Transplant Network database from 1995 to 2006 to assess the impact of reported isolated pancreas rejection on kidney allograft outcomes. The primary outcome of interest was kidney graft status beyond the first posttransplant year. RESULTS.: For overall graft survival, we found that when pancreas alone rejection was compared with no rejection there was a significant difference between the curves (log-rank P<0.0001). In addition, this endpoint was also significant for death censored graft survival (log-rank P=0.0036). For both overall and death censored graft survival the multivariate analyses demonstrated an increased risk (adjusted hazards ratio: 2.46, 3.22, respectively) for patients reported to have pancreas alone rejection. CONCLUSIONS.: These results indicate that patients with isolated pancreas rejection have worse renal allograft survival than patients reported as having no acute rejection and fare at least as poorly as those with reported kidney graft rejection supporting the concept of concordance of acute rejection in the majority of patients.

Original languageEnglish (US)
Pages (from-to)1229-1233
Number of pages5
JournalTransplantation
Volume86
Issue number9
DOIs
StatePublished - Nov 15 2008

Keywords

  • Acute rejection
  • Graft
  • Simultaneous pancreas kidney transplant
  • Survival

ASJC Scopus subject areas

  • Transplantation

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    Kaplan, B., West-Thielke, P., Herren, H., Gill, J., Knoll, G. A., Oberholzer, J., Sankary, H., & Benedetti, E. (2008). Reported isolated pancreas rejection is associated with poor kidney outcomes in recipients of a simultaneous pancreas kidney transplant. Transplantation, 86(9), 1229-1233. https://doi.org/10.1097/TP.0b013e318188ad11