Mortality assessment for pancreas transplants
Mortality assessment for pancreas transplants
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DOI：
10.1111/j.1600-6143.2004.00667.x
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发表时间：
2004-12-01
影响因子：
8.8
通讯作者：
Gruessner, AC
中科院分区：
文献类型：
--
作者：
Gruessner, RWG;Sutherland, DER;Gruessner, AC
我们通过使用器官共享联合网络（UNOS）和国际胰腺移植登记处（IPTR）的数据，确定并比较了胰腺移植受者和胰腺等待名单上患者的死亡率。从1995年1月1日至2003年5月31日，共有12478例患者接受了胰肾联合移植（SPK）; 2942例患者接受了（既往）肾移植后胰腺移植（PAK）; 1207例患者接受了单独胰腺移植（PTA）。在这项回顾性观察性队列研究中，在不同移植中心有多个列表的患者和更换移植中心的患者仅计数一次。采用社会保障死亡主文件（SSDMF）和UNOS肾移植数据库更新死亡率信息，通过单因素分析，（与移植后），在SPK类别中，为58.7%（vs. 90.3%）; PAK类，81.7%（vs. 88.3%）; PTA类，87.3%（vs. 90.5%）。在移植后90天，多达三分之一的受体死亡与移植手术本身无关。多变量分析显示，所有三种类型的总体死亡率在移植后均未增加（仅SPK受者的死亡率显著降低）。总之，单独胰腺移植受者的死亡率并不高于等待患者。
We determined and compared the mortality of pancreas transplant recipients and of patients on the pancreas waiting lists by using United Network for Organ Sharing (UNOS) and International Pancreas Transplant Registry (IPTR) data. From January 1, 1995, through May 31, 2003, a total of 12 478 patients were listed for a simultaneous pancreas-kidney (SPK) transplant; 2942 for a pancreas after (previous) kidney transplant (PAK); and 1207 for a pancreas transplant alone (PTA). In this retrospective observational cohort study, patients with multiple listings at different transplant centers and patients who changed transplant centers were counted only once. The Social Security Death Master File (SSDMF) and the UNOS kidney transplant database were used to update mortality information.By univariate analyses, 4-year patient survival rates on the waiting lists (vs. post-transplant), in the SPK category, were 58.7% (vs. 90.3%); in the PAK category, 81.7% (vs. 88.3%); and in the PTA category, 87.3% (vs. 90.5%). Up to one-third of recipient deaths after posttransplant day 90 were not related to the transplant procedure itself. Multivariate analyses showed that the overall mortality in all three categories was not increased after transplantation (for SPK recipients only, it was significantly decreased). In summary, the mortality for solitary pancreas transplant recipients is not higher than for wait-listed patients.