What happens to the kidney in an SPK transplant when the pancreas fails due to a technical complication?

Mark Hill, Raquel Garcia, Ty Dunn, Raja Kandaswamy, David E.R. Sutherland, Abhinav Humar

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

We examined a group of SPK recipients that had early (<90 d post-transplant) pancreas graft failure caused by a technical complication, and looked at outcomes of the kidney graft in these recipients. Of 289 SPK transplants, 36 (12.5%) had early pancreas graft failure because of a technical complication: thrombosis (n = 16), leak (n = 5), infection (n = 14), and pancreatitis (n = 1). Once the pancreas was lost, there was a high incidence of subsequent kidney graft failure. Kidney graft survival in these 36 recipients was 71.4% at one yr and 59.5% at three yr, significantly inferior compared to recipients that did not have early failure of the pancreas (86% at one yr and 82% at three yr, p<0.001). Of the 36 recipients with early pancreas loss, 18 have gone on to failure of the kidney graft. Causes included thrombosis (n = 3), infection (n = 1), death with function (n = 6), chronic rejection (n = 4), ischemia (n = 1), and other (n = 3). Of the 18 kidney graft failures, nine occurred within three months after loss of the pancreas graft, usually either because of graft thrombosis, or patient death (usually from systemic sepsis). Multivariate analysis showed technical failure of the pancreas to be the most significant risk factor for kidney graft loss (HR = 2.08, p = 0.006).

Original languageEnglish (US)
Pages (from-to)456-461
Number of pages6
JournalClinical Transplantation
Volume22
Issue number4
DOIs
StatePublished - Jul 2008

Keywords

  • Kidney graft outcome
  • Kidney transplant
  • Simultaneous pancreas
  • Technical failure

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