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Influence of dialysis duration on outcomes of simultaneous pancreas‐kidney transplant
Author(s) -
Dong Yinlei,
Zhou Jie,
Li Zhiwei,
Xiang Jie,
Mei Shengmin,
Gu Yangjun,
Zheng Huilin,
Chen Zheng,
Huang Zhichao,
Xu Fangshen,
Hu Zhenhua
Publication year - 2021
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.14238
Subject(s) - medicine , dialysis , proportional hazards model , diabetes mellitus , transplantation , surgery , kidney transplantation , univariate analysis , survival analysis , multivariate analysis , endocrinology
Objective The objective of this study was to assess how pre‐transplant dialysis duration affects transplant outcomes after simultaneous pancreas‐kidney transplant (SPK) in patients with type 1 diabetes mellitus (T1DM). Methods Data of 6887 T1DM patients who underwent SPK transplantation between 2008 and 2018 were obtained from the Scientific Registry of Transplant Recipients database. According to pre‐transplant dialysis duration, the patients were divided into the preemptive SPK, 0‐2 years, 2‐5 years, and >5 years dialysis groups. Kaplan‐Meier survival analysis was performed to compare patient and graft survival among the groups. Univariate and multivariate Cox regression analyses were used to identify predictors of transplant outcomes. Results The mean follow‐up period was 56.7 ± 34.7 months. Compared with no dialysis or preemptive SPK, dialysis for 0‐2 years was not significantly associated with patient or kidney graft survival, while long‐term dialysis of 2‐5 years and >5 years was significantly associated with increased risk of death and kidney graft failure. However, the duration of dialysis was not associated with pancreas graft survival. Conclusion Long‐term dialysis duration before SPK transplant is an independent predictor of patient death and kidney graft failure in T1DM patients.