Recipient Age and Outcomes Following Simultaneous Pancreas-Kidney Transplantation in the New Millennium: Single Center Experience and Review of the Literature
Berjesh Sharda1, Komal Gurung1, Jennifer Alejo1, J. Rogers1, Alan Farney1, G. Orlando1, C. Jay1, Reeves Daniel2, Mena Gutierrez2, N. Sakhovskaya2, William Doares3, S. Kaczmorski3, Michael D. Gautreaux4, Robert Stratta1.
1Transplant Surgery, Wake Forest Baptist Health, Winston Salem, NC, United States; 2Internal Medicine Section of Nephrology, Wake Forest Baptist Health, Winston Salem, NC, United States; 3Pharmacy, Wake Forest Baptist Hospital, Winston Salem, NC, United States; 4Pathology, Wake Forest Baptist Hospital, Winston Salem, NC, United States
Introduction: The influence of recipient age on outcomes following simultaneous pancreas-kidney transplantation (SPKT) in the modern era is uncertain.
Methods: We retrospectively studied 255 patients undergoing SPKT from 11/01 to 8/20. Recipients were stratified according to age group: age <30 years (n=16); age 30-39 years (n=91); age 40-49 years (n=86), and age ≥ 50 years (n=62 [24.3%], including 9 patients ≥60 years of age).
Results: Three-month and one-year outcomes were comparable. The eight-year patient survival rate was lowest in the oldest age group (47.6% versus 78% in the 3 younger groups combined, p<0.001). However, eight-year kidney and pancreas graft survival rates were comparable in the youngest and oldest age groups combined (36.5% and 32.7%, respectively), but inferior to those in the middle 2 groups combined (62% and 50%, respectively, both p<0.05). Death-censored kidney and pancreas graft survival rates increased from youngest to oldest recipient age category because of a higher incidence of death with functioning grafts (22.6% in oldest group compared to 8.3% in the 3 younger groups combined, p=0.005).
Conclusions: Recipient age did not appear to significantly influence early outcomes following SPKT. Late outcomes are similar in younger and older recipients, but inferior to the middle 2 age groups.