TY - JOUR
T1 - Recipient age and outcome after pancreas transplantation
T2 - a retrospective dual-center analysis
AU - Messner, Franka
AU - Leemkuil, Marjolein
AU - Yu, Yifan
AU - Massie, Allan B.
AU - Krendl, Felix J.
AU - Benjamens, Stan
AU - Bösmüller, Claudia
AU - Weissenbacher, Annemarie
AU - Schneeberger, Stefan
AU - Pol, Robert A.
AU - Margreiter, Christian
N1 - Funding Information:
The authors thank Prof. Hanno Ulmer from the Department of Medical Statistics, Informatics and Health Economics at the Medical University of Innsbruck, Austria, for his advice on interaction analyses.
Publisher Copyright:
© 2021 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.
PY - 2021/4
Y1 - 2021/4
N2 - With a later onset of diabetes complications and thus increasing age of transplant candidates, many centers have extended upper age limits for pancreas transplantation. This study investigates the effect of recipient and donor age on outcomes after pancreas transplantation.We retrospectively analyzed 565 pancreas transplants performed at two Eurotransplant centers. The cohort was split at a recipient and donor age of 50 and 40 years, respectively. Median recipient age in old patients (≥50 years; 27.2%) was 54 years and 40 years in young patients (<50 years). Compared to young recipients, old recipients had an inferior patient survival rate (≥50: 5yr, 82.8%; 10yr, 65.6%; <50: 5yr, 93.3%; 10yr, 82.0%; P < 0.0001). Old recipients demonstrated comparable death-censored pancreas (≥50: 1yr, 80.6%; 5yr, 70.2%; <50: 1yr, 87.3%; 5yr, 77.8%; P = 0.35) and kidney graft survival (≥50: 1yr, 97.4%; 5yr, 90.6%; <50: 1yr, 97.8%; 5yr, 90.2%; P = 0.53) compared to young recipients. Besides a lower rate of kidney rejection, similar relative risks for postoperative complications were detected in old and young patients. This study shows that despite an increased mortality in old recipients, excellent graft survival can be achieved similar to that of young patients. Age alone should not exclude patients from receiving a pancreas transplant.
AB - With a later onset of diabetes complications and thus increasing age of transplant candidates, many centers have extended upper age limits for pancreas transplantation. This study investigates the effect of recipient and donor age on outcomes after pancreas transplantation.We retrospectively analyzed 565 pancreas transplants performed at two Eurotransplant centers. The cohort was split at a recipient and donor age of 50 and 40 years, respectively. Median recipient age in old patients (≥50 years; 27.2%) was 54 years and 40 years in young patients (<50 years). Compared to young recipients, old recipients had an inferior patient survival rate (≥50: 5yr, 82.8%; 10yr, 65.6%; <50: 5yr, 93.3%; 10yr, 82.0%; P < 0.0001). Old recipients demonstrated comparable death-censored pancreas (≥50: 1yr, 80.6%; 5yr, 70.2%; <50: 1yr, 87.3%; 5yr, 77.8%; P = 0.35) and kidney graft survival (≥50: 1yr, 97.4%; 5yr, 90.6%; <50: 1yr, 97.8%; 5yr, 90.2%; P = 0.53) compared to young recipients. Besides a lower rate of kidney rejection, similar relative risks for postoperative complications were detected in old and young patients. This study shows that despite an increased mortality in old recipients, excellent graft survival can be achieved similar to that of young patients. Age alone should not exclude patients from receiving a pancreas transplant.
KW - donor age
KW - postoperative complications
KW - recipient age
KW - simultaneous pancreas kidney transplantation
KW - survival
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U2 - 10.1111/tri.13845
DO - 10.1111/tri.13845
M3 - Article
C2 - 33570795
AN - SCOPUS:85101881811
SN - 0934-0874
VL - 34
SP - 657
EP - 668
JO - Transplant International
JF - Transplant International
IS - 4
ER -