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The significance of pre‐operative coronary interventions on outcome after pancreas transplantation
Author(s) -
Laurence Jerome M.,
Barbas Andrew S.,
Sapisochin Gonzalo,
Marquez Max A.,
Bazerbachi Fateh,
Selzner Markus,
Norgate Andrea,
McGilvray Ian D.,
Schiff Jeffrey,
Ross Heather,
Cattral Mark S.
Publication year - 2016
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12681
Subject(s) - medicine , pancreas transplantation , transplantation , outcome (game theory) , psychological intervention , surgery , intensive care medicine , kidney transplantation , nursing , mathematics , mathematical economics
Abstract Pancreas transplant candidates are at very high risk of coronary vascular disease. We hypothesized that the requirement for pre‐operative coronary intervention ( PCI ) may be associated with an adverse impact on short‐ and long‐term outcomes. Retrospective analysis of 366 consecutive primary pancreas transplants was undertaken. Outcomes were compared between recipients who had undergone PCI (n = 48) and those who had not (n = 318). In 48% (23/48) of instances, the PCI was initiated by the transplant cardiology evaluation. The recipients undergoing PCI were older than those not undergoing PCI (47.6 yr vs. 41.9 yr, respectively, p < 0.0001). Although not statistically significant, there was a higher rate of post‐operative major cardiovascular events ( MCVE ) in the PCI group (10.4%) compared with those not undergoing PCI (4.7%) ( RR [95% CI ]: 2.0 [0.90–4.5]; p = 0.17). In the long term, there were no differences in the rate of death with graft function (p = 0.77) or rejection (p = 0.17). There were no statistically significant differences between the groups with respect to patient (p = 0.54), kidney (p = 0.76), or pancreas (p = 0.63) graft survival. PCI is not a risk factor for short‐term perioperative events, and long‐term transplant outcomes are equivalent to patients not requiring PCI . PCI , by itself, should not be considered a contraindication for pancreas transplantation, but should raise awareness of perioperative risk.