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胰腺供体风险指数和获取前胰腺分配适宜性评分的效用:波兰全国性研究结果

Usefulness of Pancreas Donor Risk Index and Pre-Procurement Pancreas Allocation Suitability Score: Results of the Polish National Study.

作者信息

Śmigielska Kaja, Skrzypek Paweł, Czerwiński Jarosław, Michalak Grzegorz, Durlik Marek, Grochowiecki Tadeusz, Nazarewski Sławomir, Szmidt Jacek, Ziaja Jacek, Król Robert, Cierpka Lech, Lisik Wojciech, Kosieradzki Maciej

机构信息

Department of General, Vascular and Transplantation Surgery, The Medical University of Warsaw, Warsaw, Poland.

Department of General and Transplantation Surgery, The Medical University of Warsaw, Warsaw, Poland.

出版信息

Ann Transplant. 2018 May 25;23:360-363. doi: 10.12659/AOT.909654.

Abstract

BACKGROUND Pre-procurement pancreas suitability score (P-PASS) and pancreas donor risk (PDRI) index are scoring systems believed to predict suitability of pancreatic grafts. Most European countries and the United States apply PDRI, while Poltransplant keeps using P-PASS: more than 16 points raises a red flag for graft use. Recent data discourage use of PDRI to predict pancreas graft survival. The aim of the present study was to assess PDRI and P-PASS as predictors of transplanted pancreas survival in a Polish population. MATERIAL AND METHODS From February 1998 to September 2015, 407 pancreas transplantations were performed in Poland: 370 (90.9%) simultaneous pancreas-kidney transplantation and 37 (9.1%) pancreas transplantation alone or pancreas after kidney. The endpoint was death-uncensored 12-month graft survival with satisfactory glycemic control without insulin. RESULTS Average P-PASS was 15.9±2.66 and PDRI was 0.96±0.37. Recipients who survived 12 months with good graft function had an average P-PASS score of 15.7 and PDRI of 0.95. Recipients with death-uncensored graft loss had a mean P-PASS of 16.4 and PDRI of 0.99. Univariate analysis revealed donor age, body mass index (BMI), and P-PASS to be significant risk factors for 1-year pancreas graft survival. CONCLUSIONS P-PASS, but not PDRI, is a reliable tool to predict pancreas graft survival in the Polish population.

摘要

背景

胰腺采购前适宜性评分(P-PASS)和胰腺供体风险指数(PDRI)是据信可预测胰腺移植物适宜性的评分系统。大多数欧洲国家和美国采用PDRI,而波兰移植中心仍在使用P-PASS:超过16分提示移植物使用存在警示信号。近期数据不支持使用PDRI来预测胰腺移植物存活。本研究的目的是评估PDRI和P-PASS作为波兰人群中移植胰腺存活预测指标的情况。

材料与方法

1998年2月至2015年9月,波兰共进行了407例胰腺移植:370例(90.9%)为胰肾联合移植,37例(9.1%)为单纯胰腺移植或肾移植后胰腺移植。终点指标为未校正死亡的12个月移植物存活,血糖控制良好且无需胰岛素。

结果

P-PASS平均为15.9±2.66,PDRI平均为0.96±0.37。移植物功能良好存活12个月的受者,P-PASS平均评分为15.7,PDRI为0.95。未校正死亡的移植物丢失受者,P-PASS平均为16.4,PDRI为0.99。单因素分析显示供体年龄、体重指数(BMI)和P-PASS是1年胰腺移植物存活的显著危险因素。

结论

在波兰人群中,P-PASS是预测胰腺移植物存活的可靠工具,而PDRI不是。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d0/6248280/81b4dfa51ea0/anntransplant-23-360-g001.jpg

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