ECE2017 Eposter Presentations: Diabetes, Obesity and Metabolism Diabetes therapy (52 abstracts)
Pancreas transplantation: experience in a central hospital
Ana Cláudia Martins 1 , Miguel Vasques 1 , Paula Bogalho 1 , Inês Aires 2 , Aníbal Ferreira 2 , Francisco Remédio 2 , Jorge Paulino 3 , Fernando Nolasco 2 , Américo Martins 3 & Ana Agapito 1
1Department of Endocrinology, Centro Hospitalar Lisboa Central, Lisbon, Portugal; 2Department of Nephrology, Centro Hospitalar Lisboa Central, Lisbon, Portugal; 3Department of Surgery, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
Introduction: Pancreas transplantation is an established treatment for selected patients with type 1 diabetes mellitus (T1DM) and severe chronic kidney disease (CKD), reducing mortality and morbidity.
Methods: We retrospectively reviewed the cases of pancreas transplantation performed at our centre from 1-January-2011 to 30-June-2016.
Results: In this period, 53 transplants were performed: 48 simultaneous pancreas-kidney transplants and 5 pancreas after kidney. Age at time of transplantation was 38±7 years; 34 were male (64.2%). Patients had T1DM for an average of 26±8 years (age at diagnosis: 12±5 years). All patients had severe CKD, 78.4% on hemodialysis and 15.7% on peritoneal dialysis. Major postoperative complications occurred in 23 cases (43.4%): 8 infectious, 8 haemorrhagic, 7 thrombotic. Pancreas graft survival was 86.7% at 1 year (39/45) and 83.3% after 2 years (30/36). Kidney graft survival was 92.7% at 1 year (38/41) and 90.6% after 2 years (29/32). Graft failure ensued in 6 pancreatic grafts and 3 transplanted kidneys. There were 12 acute organ rejections (22.6%). Three patients died (5.9%), 2 from infection, one from haemorrhagic shock. Patients had, on average, 2 hospital readmissions, mainly due to infection. Among those with preserved pancreatic grafts, 93.2% are insulin-free. Over the last 2 years, compared to the first 2 years, there were more transplants performed (23 vs 13), fewer postoperative complications (30.4% vs 61.5%) and higher 1-year pancreas graft survival rate (93.8% vs 69.2%). Young age at diagnosis of T1DM was negatively related to pancreas and kidney graft survival (P<0.05). Duration of dialysis and coronary disease were negatively related to renal graft survival (P<0.05).
Conclusions: Patient and graft survival rates were similar to those described in literature. Better outcomes observed in recent years reflect the experience acquired. Young age of onset of T1DM, duration of dialysis and coronary disease may represent poor prognostic factors concerning graft function.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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