Pancreas Transplantation: Does Age Increase Morbidity?

Introduction. Pancreas transplantation (PTx) is the only definitive intervention for type 1 diabetes. Medical advancements in diabetes care have led to an aging PTx candidate pool. We report our experience with patients ≥50 years of age undergoing PTx. Methods. We reviewed 136 consecutive PTx patients at our institution from 1996–2010; 17 were ≥50 years of age. We evaluated demographics, surgical complications, acute rejection (AR) rates, nonsurgical infections, and survival outcomes. Results. Demographic data was similar (P > .05) between groups, excluding age. The two groups had comparable major and minor surgical complication rates (P = .10 and P = .25, resp.). The older group had a lower 1-year and overall AR rate (P = .04 and P = .03, resp.). The incidence of non-surgical infections and overall patient and graft survival was similar between groups (P > .05). Conclusion. Older patients with type 1 diabetes are feasible candidates for PTx, as surgical morbidity, incidence of infections, and AR rates are low.

[1]  B. Krämer,et al.  Long‐term results of pancreas transplantation in patients older than 50 years , 2011, Transplant international : official journal of the European Society for Organ Transplantation.

[2]  U. Boggi,et al.  Pancreas transplantation outside the USA: an update , 2011, Current opinion in organ transplantation.

[3]  D. Sutherland,et al.  Pancreas transplantation in the United States: a review , 2010, Current opinion in organ transplantation.

[4]  E. Xirouchakis,et al.  Brocklehurst's textbook of geriatric medicine and gerontology , 2009 .

[5]  R. Viebahn,et al.  Incidence of pancreas graft thrombosis using low‐molecular‐weight heparin , 2009, Clinical transplantation.

[6]  R. Pararajasingam,et al.  Outcome of Pancreas Transplantation in Recipients Older Than 50 Years: A Single-Centre Experience , 2008, Transplantation.

[7]  M. Schnitzler,et al.  Patient and Graft Survival Implications of Simultaneous Pancreas Kidney Transplantation From Old Donors , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[8]  D. Sutherland,et al.  Pancreas transplant outcomes for United States (US) and non‐US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of June 2004 , 2005, Clinical transplantation.

[9]  N. Demartines,et al.  Classification of Surgical Complications: A New Proposal With Evaluation in a Cohort of 6336 Patients and Results of a Survey , 2004, Annals of Surgery.

[10]  H. Parving,et al.  Decreasing incidence of severe diabetic microangiopathy in type 1 diabetes. , 2003, Diabetes care.

[11]  D. Dunn,et al.  Lessons Learned From More Than 1,000 Pancreas Transplants at a Single Institution , 2001, Annals of surgery.

[12]  R. Wolfe,et al.  THE IMPACT OF SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION ON LONG-TERM PATIENT SURVIVAL1 , 2001, Transplantation.

[13]  J. Leypoldt,et al.  Solute fluxes in different treatment modalities. , 2000, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[14]  R. Kandaswamy,et al.  Decreased surgical risks of pancreas transplantation in the modern era. , 2000, Annals of surgery.

[15]  P. Stock,et al.  Increased morbidity and mortality of simultaneous pancreas-renal transplantation in patients over 49 years of age. , 1998, Transplantation proceedings.

[16]  M. Henry,et al.  Renal transplantation in older people , 1994, The Lancet.

[17]  H. Reimann,et al.  RESPIRATORY DISEASES , 1937, Medicine of the year.

[18]  R. Viebahn,et al.  Is pancreas transplantation getting old? Single-center experience in an aging society. , 2009, Clinical transplants.

[19]  D. Sutherland,et al.  Pancreas transplant outcomes for United States (US) cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR). , 2008, Clinical transplants.

[20]  D. Sutherland,et al.  Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of May 2003. , 2003, Clinical transplants.

[21]  G. Danovitch,et al.  Kidney allograft and patient survival in type I diabetic recipients of cadaveric kidney alone versus simultaneous pancreas kidney transplants: a multivariate analysis of the UNOS database. , 2003, Journal of the American Society of Nephrology : JASN.

[22]  J. Light,et al.  Renal transplantation for older patients. , 1988, Transplantation proceedings.

[23]  J. Cameron,et al.  Renal transplantation in older patients , 1987 .

[24]  J. Howie Respiratory infections. , 2009, The British journal of general practice : the journal of the Royal College of General Practitioners.

[25]  R E PUPI,et al.  [Diabetes in old age]. , 1960, Medicina panamericana.