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Risk analysis for deterioration of renal function after pancreas alone transplant


Chatzizacharias, N A; Vaidya, A; Sinha, S; Sharples, E; Smith, R; Jones, G; Brockmann, J; Friend, P J (2012). Risk analysis for deterioration of renal function after pancreas alone transplant. Clinical Transplantation, 26(3):387-392.

Abstract

Chatzizacharias NA, Vaidya A, Sinha S, Sharples E, Smith R, Jones G, Brockmann J, Friend PJ. Risk analysis for deterioration of renal function after pancreas alone transplant. Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01534.x. © 2011 John Wiley & Sons A/S. Abstract:  The risk of progression to renal replacement after pancreas transplant alone (PTA) is a concern in patients with pre-transplant estimated glomerular filtration rate (eGFR) <70 mL/min/1.73 m(2) . This is a retrospective, single-center risk analysis of potential factors affecting renal function after PTA. Twenty-four patients, transplanted over a three-yr period, with functioning pancreatic grafts at the study's end point were included. High tacrolimus levels (>12 mg/dL) at six months post-transplant was the only independent risk factor identifying a substantial decline in native renal function by Cox regression analysis (HR = 14.300, CI = 1.271-160.907, p = 0.031). The presence of severe pre-transplant proteinuria (urine Pr/Cr ≥100 mg/mmol) marginally failed to reach significance (p = 0.056). Low eGFR levels alone (≤45 and ≤40 mL/min/1.73 m(2) ) at the time of transplant did not correlate with substantial decline in renal function. Our data suggest that PTA is a justifiable therapy for patients with hypoglycemia unawareness or other life-threatening diabetic complications, even in those with borderline renal function, provided that they do not suffer from severe proteinuria and appropriate monitoring and tailoring of immunosuppression is ensured.

© 2011 John Wiley & Sons A/S.

Abstract

Chatzizacharias NA, Vaidya A, Sinha S, Sharples E, Smith R, Jones G, Brockmann J, Friend PJ. Risk analysis for deterioration of renal function after pancreas alone transplant. Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01534.x. © 2011 John Wiley & Sons A/S. Abstract:  The risk of progression to renal replacement after pancreas transplant alone (PTA) is a concern in patients with pre-transplant estimated glomerular filtration rate (eGFR) <70 mL/min/1.73 m(2) . This is a retrospective, single-center risk analysis of potential factors affecting renal function after PTA. Twenty-four patients, transplanted over a three-yr period, with functioning pancreatic grafts at the study's end point were included. High tacrolimus levels (>12 mg/dL) at six months post-transplant was the only independent risk factor identifying a substantial decline in native renal function by Cox regression analysis (HR = 14.300, CI = 1.271-160.907, p = 0.031). The presence of severe pre-transplant proteinuria (urine Pr/Cr ≥100 mg/mmol) marginally failed to reach significance (p = 0.056). Low eGFR levels alone (≤45 and ≤40 mL/min/1.73 m(2) ) at the time of transplant did not correlate with substantial decline in renal function. Our data suggest that PTA is a justifiable therapy for patients with hypoglycemia unawareness or other life-threatening diabetic complications, even in those with borderline renal function, provided that they do not suffer from severe proteinuria and appropriate monitoring and tailoring of immunosuppression is ensured.

© 2011 John Wiley & Sons A/S.

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1 citation in Web of Science®
2 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Visceral and Transplantation Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:02 Mar 2012 22:37
Last Modified:05 Apr 2016 15:28
Publisher:Wiley-Blackwell
ISSN:0902-0063
Publisher DOI:https://doi.org/10.1111/j.1399-0012.2011.01534.x
PubMed ID:21980989

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