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Risk analysis for deterioration of renal function after pancreas alone transplant
Author(s) -
Chatzizacharias Nikolaos A.,
Vaidya Anil,
Sinha Sanjay,
Sharples Edward,
Smith Richard,
Jones Gareth,
Brockmann Jens,
Friend Peter J.
Publication year - 2011
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/j.1399-0012.2011.01534.x
Subject(s) - medicine , renal function , proteinuria , urology , immunosuppression , risk factor , transplantation , diabetes mellitus , renal transplant , tacrolimus , hypoglycemia , pancreas transplantation , retrospective cohort study , kidney , gastroenterology , kidney transplantation , endocrinology
Chatzizacharias NA, Vaidya A, Sinha S, Sharples E, Smith R, Jones G, Brockmann J, Friend PJ. Risk analysis for deterioration of renal function after pancreas alone transplant.
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01534.x.
© 2011 John Wiley & Sons A/S. Abstract: The risk of progression to renal replacement after pancreas transplant alone (PTA) is a concern in patients with pre‐transplant estimated glomerular filtration rate (eGFR) <70 mL/min/1.73 m 2 . This is a retrospective, single‐center risk analysis of potential factors affecting renal function after PTA. Twenty‐four patients, transplanted over a three‐yr period, with functioning pancreatic grafts at the study’s end point were included. High tacrolimus levels (>12 mg/dL) at six months post‐transplant was the only independent risk factor identifying a substantial decline in native renal function by Cox regression analysis (HR = 14.300, CI = 1.271–160.907, p = 0.031). The presence of severe pre‐transplant proteinuria (urine Pr/Cr ≥100 mg/mmol) marginally failed to reach significance (p = 0.056). Low eGFR levels alone (≤45 and ≤40 mL/min/1.73 m 2 ) at the time of transplant did not correlate with substantial decline in renal function. Our data suggest that PTA is a justifiable therapy for patients with hypoglycemia unawareness or other life‐threatening diabetic complications, even in those with borderline renal function, provided that they do not suffer from severe proteinuria and appropriate monitoring and tailoring of immunosuppression is ensured.