A composite risk model for predicting technical failure in pancreas transplantation. Am J Transplant 2013 Jul;13(7):1840-9
Date
05/29/2013Pubmed ID
23711225Pubmed Central ID
PMC3696030DOI
10.1111/ajt.12269Scopus ID
2-s2.0-84879554040 (requires institutional sign-in at Scopus site) 84 CitationsAbstract
Technical failure (TF) continues to have a significant impact on the success of pancreas transplantation. We assessed risk factors for TF in 1115 pancreas transplants performed at a single center between 1998 and 2011. The overall TF rate was 10.2%. In a multivariable model, donor BMI ≥ 30 (HR 1.87, p = 0.005), donor Cr ≥ 2.5 (HR 3.16, p = 0.007), donor age >50 (HR 1.73, p = 0.082) and preservation time >20 h (HR 2.17, p < 0.001) were associated with TF. Bladder drainage of exocrine secretions was protective (HR 0.54, p = 0.002). We incorporated these factors in a Composite Risk Model. In this model the presence of one risk factor did not significantly increase risk of TF (HR 1.35, p = 0.346). Two risk factors in combination increased risk greater than threefold (HR 3.65, p < 0.001) and three risk factors increased risk greater than sevenfold (HR 7.66, p = <0.001). The analysis also identified many factors that were not predictive of TF, including previous transplants, immunosuppressive agent selection, and almost all recipient demographic parameters. While the model suggests that two or more risk factors predict TF, strategies to reduce preservation time may mitigate some of this risk.
Author List
Finger EB, Radosevich DM, Dunn TB, Chinnakotla S, Sutherland DE, Matas AJ, Pruett TL, Kandaswamy RAuthor
Ty Blink Dunn MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
FemaleFollow-Up Studies
Graft Rejection
Humans
Male
Middle Aged
Pancreas Transplantation
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Survival Rate
Tissue and Organ Procurement
Treatment Failure
United States
