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Pancreas-Kidney Transplantation: Analysis of 150 patients from one Centre in Portugal

2013Journal article Open access
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dc.contributor.authorMartins, La Salete
dc.contributor.authorFonseca, Isabel
dc.contributor.authorAguiar, P.
dc.contributor.authorRocha, A.
dc.contributor.authorCosta, R.
dc.contributor.authorSantos, C.
dc.contributor.authorMalheiro, J.
dc.contributor.authorPedroso, S.
dc.contributor.authorAlmeida, M.
dc.contributor.authorDias, L.
dc.contributor.authorCastro-Henriques, A.
dc.contributor.authorCabrita, A.
dc.contributor.authorDavide, J.
dc.date.accessioned2013-12-26T18:46:47Z
dc.date.available2013-12-26T18:46:47Z
dc.date.issued2013
dc.description.abstractIntroduction: Simultaneous pancreas-kidney transplantation (SPKT) outcomes are conditioned in the short-term mostly by post-operative complications. In the long-term, cardiovascular (CV) disease and immunological loss are the main limitations to transplant survival. Aims: To analyse retrospectively the results from 150 SPKT performed at our centre. Patients and Methods: The 81 females and 69 males had a mean age of 35±6 years; they were diabetic for 24±6 years and had been on dialysis for 30±21months (except 5 preemptive). Anti-lymphocyte globulin, tacrolimus, mycophenolate and steroids were used as immunosuppressive therapy. Deceased-donor mean age was 28±11 years. In 28.7% the transplant was performed with 6 HLA-mismatches. Results: Acute rejection’s incidence was 16%. Ten SPKT patients died; infection was the leading cause of death (five cases), followed by Cardiovascular/cerebrovascular disease (three cases). In 21 patients the pancreas failed, mainly due to thrombosis or bleeding (11 cases), and infection (five cases); in two it was due to late acute rejection. In four patients only the kidney failed, due to chronic rejection. Five patients lost both grafts, from late acute rejection in four and thrombosis in one. We analyzed the 110 SPKT patients (73.3%) with both grafts functioning. Their mean serum creatinine was 1.2±0.4mg/dl; creatinineclearance was 76±24 ml/min; fasting glycaemia was 81±10mg/dl; and HbA1c was 5.3±0.4%. Hypertension has been treated in 47.2% of patients, in the majority (28.2%) with only one drug. Hyperlipidaemia was observed in 19.1% and excessive weight (>25kg/m2) in 17.3%. Conclusions: From our cohort of SPKT, 93.3% of patients are alive, 73.3% have both grafts functioning. Rejection was the main cause of late pancreas loss. Early mortality was due to infection (3.3%). CV/cerebrovascular disease was the main cause of late mortality (2%). The prevalence of hyperlipidaemia and overweight was inferior to 20%. Hypertension was the most frequently found CV risk factor.por
dc.identifier.citationPort J Nephrol Hypert 2013; 27(3): 173-178por
dc.identifier.issn2183-1289
dc.identifier.urihttp://hdl.handle.net/10400.16/1547
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherSociedade Portuguesa de Nefrologiapor
dc.relation.publisherversionhttp://www.spnefro.pt/RPNH/PDFs/n3_2013/artigo_06.pdfpor
dc.subjectgraft losspor
dc.subjectlong-term resultspor
dc.subjectpancreas-kidney transplantationpor
dc.subjectpatient deathpor
dc.titlePancreas-Kidney Transplantation: Analysis of 150 patients from one Centre in Portugalpor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlacePortugalpor
oaire.citation.endPage178por
oaire.citation.issue3por
oaire.citation.startPage173por
oaire.citation.titlePortuguese Journal of Nephrology Hypertensionpor
oaire.citation.volume27por
person.familyNameMartins
person.familyNameFonseca
person.givenNameLa Salete
person.givenNameIsabel
person.identifier1911437
person.identifier415128
person.identifier.ciencia-id7A1B-8631-FC46
person.identifier.ciencia-id6716-A5D1-FB3F
person.identifier.orcid0000-0002-6110-2102
person.identifier.orcid0000-0001-8984-1751
person.identifier.ridK-6339-2013
person.identifier.scopus-author-id56207848700
person.identifier.scopus-author-id55941495000
rcaap.rightsopenAccesspor
rcaap.typearticlepor
relation.isAuthorOfPublication71fef9db-e03d-423a-af46-2909891b037d
relation.isAuthorOfPublication2c7a2607-6376-486e-9ad5-490d0032946c
relation.isAuthorOfPublication.latestForDiscovery71fef9db-e03d-423a-af46-2909891b037d

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