The Importance and Utility of Hemoglobin A1c Levels in the Assessment of Donor Pancreas Allografts
The Importance and Utility of Hemoglobin A1c Levels in the Assessment of Donor Pancreas Allografts
复制标题
糖化血红蛋白水平在评估供体胰腺同种异体移植物中的重要性和实用性
作者：
E. Arpalı;J. Scalea;R. Redfield;Lynn Berg;D. Kaufman;H. Sollinger;Bridget Welch;G. Leverson;J. Odorico
背景：潜在的胰腺移植供者通常检测血红蛋白A1c(HbA1c)水平，以评估整体的长期功能性血糖控制或未被识别的糖尿病的可能性。虽然常规测量，但供者HbA1c水平对胰腺移植结果的影响尚未见报道。在这里，我们研究了供者HbA1c水平与胰腺移植术后存活率的关系。方法回顾分析了266例胰腺移植患者的临床资料，其中肾-胰腺联合移植182例，单纯胰腺移植84例。按糖化血红蛋白水平分为5组：糖化血红蛋白5.0、5.0~5.4、5.5~5.9、≥6.0%和不可用；2组：糖化血红蛋白5.7、≥5.7%。总体而言，比较了每组死亡审查和技术成功的胰腺移植的存活率和排斥率。在移植物在技术上成功存活的情况下，不包括前60天因技术问题造成的移植物损失。结果供体变量包括年龄、性别、ABO血型、种族、供体类型和受体变量包括受者年龄、性别、诱导剂和维持治疗。平均随访时间(4.2±1.97)年。不同组间的整体移植物存活率和死亡审查移植物存活率之间没有统计学差异(P>；0.05)。此外，排除18名患者的早期技术损失并未显示移植物存活率有任何差异。患者存活率和活检证实的急性排斥反应在HbA1c各层之间统计上相似。结论对单个中心/器官采购组织使用HbA1c的单变量回顾分析表明，供者HbA1c水平在3.5至6.2之间的其他可移植胰腺与不同的短期结果无关。
Background Hemoglobin A1C (HbA1c) levels are often obtained in potential pancreas graft donors to assess the overall long-term functional glycemic control or the possibility of unrecognized diabetes. Although routinely measured, the impact of donor HbA1c levels on pancreas graft outcomes has not been reported. Here, we researched the relationship between donor HbA1c levels and postoperative pancreas graft survival. Methods Data from 266 pancreas transplant patients including 182 simultaneous kidney-pancreas and 84 pancreas alone transplants were reviewed for the study. The patients were separated into groups according to their HbA1c levels (5 groups: HbA1c < 5.0, 5.0-5.4, 5.5-5.9, ≥6.0 % and not available, or 2 groups: HbA1c <5.7, ≥5.7%). Overall, death-censored and technically successful pancreas graft survival and rejection rates of each group were compared. In the case of technically successful graft survival, graft losses due to technical problems in the first 60 days were excluded. Results All groups were similar with regard to donor variables including age, sex, ABO blood type, ethnicity, donor type and recipient variables including recipient age, sex, induction agents and maintenance treatment. Mean follow-up time was 4.2 ± 1.97 years. The overall graft survivals and death censored graft survivals among groups were not statistically different from one other (P > 0.05). Additionally, excluding early technical losses in 18 patients did not reveal any differences in graft survivals. Patient survival and biopsy-proven acute rejections were statistically similar among HbA1c strata. Conclusions This univariate retrospective analysis of a single center/organ procurement organization use of HbA1c shows that donor HbA1c levels between 3.5 and 6.2 in otherwise transplantable pancreata are not associated with different short-term outcomes.
影响因子：
5.8
作者：
Herman, William H.;Cohen, Robert M.
通讯作者：
Cohen, Robert M.