Siskind Eric, Maloney Caroline, Jayaschandaran Vivek, Kressel Adam, Akerman Meredith, Shen Adam, Amodu Leo, Platz John, Ricci John P, Bhaskaran Madhu, Basu Amit, Molmenti Ernesto, Ortiz Jorge
From the Department of Transplantation, North Shore Long Island Jewish Health System-Hofstra University School of Medicine, Manhasset, NY.
Pancreas. 2015 Jul;44(5):769-72. doi: 10.1097/MPA.0000000000000330.
The aim of the study was to assess outcomes of pancreas retransplantation versus primary pancreas transplantation.
Data from the United Network for Organ Sharing database on all adult (age, ≥18 years) subjects who received pancreas and kidney-pancreas transplants between 1996 and 2012 were analyzed (n = 20,854). The subjects were analyzed in the following 2 groups: retransplant (n = 1149) and primary transplant (n = 19,705).
Kaplan-Meier analysis demonstrated significantly different patient survival (P < 0.0001) and death-censored graft survival (P < 0.0001) between the primary transplant versus retransplant subjects. Allograft survival was significantly poorer in the retransplantation group. Patient survival was greater in the retransplant group.
The results of our study differ from previous studies, which showed similar allograft survival in primary and secondary pancreas transplants. Further studies may elucidate specific patients who will benefit from retransplantation. At the present time, it would appear that pancreas retransplantation is associated with poor graft survival and that retransplantation should not be considered for all patients with primary pancreatic allograft failure.
本研究的目的是评估胰腺再次移植与初次胰腺移植的结果。
分析了器官共享联合网络数据库中1996年至2012年间接受胰腺移植和肾-胰腺联合移植的所有成年(年龄≥18岁)受试者的数据(n = 20854)。将受试者分为以下两组进行分析:再次移植组(n = 1149)和初次移植组(n = 19705)。
Kaplan-Meier分析显示,初次移植受试者与再次移植受试者之间的患者生存率(P < 0.0001)和死亡删失移植物生存率(P < 0.0001)存在显著差异。再次移植组的同种异体移植物生存率明显较差。再次移植组的患者生存率更高。
我们的研究结果与之前的研究不同,之前的研究显示初次和二次胰腺移植的同种异体移植物生存率相似。进一步的研究可能会阐明哪些特定患者将从再次移植中获益。目前,似乎胰腺再次移植与移植物生存率低相关,并且不应为所有初次胰腺同种异体移植物失败的患者考虑再次移植。