Efficacy and safety of simultaneous pancreas-kidney transplantation in patients aged over 60 years
10.3760/cma.j.cn421203-20200421-00129
- VernacularTitle:60岁以上受者行胰肾联合移植的安全性分析
- Author:
Jie ZHAO
1
;
Yingxin FU
;
Wenli SONG
;
Chunbai MO
;
Hui WANG
;
Gang FENG
;
Yu CAO
Author Information
1. 天津市第一中心医院移植外科 天津市器官移植重点实验室 300192
- Keywords:
Pancreas transplantation;
Kidney transplantation;
Cardiovascular disease
- From:
Chinese Journal of Organ Transplantation
2021;42(4):229-233
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of simultaneous pancreas-kidney (SPK) transplantation in patients aged over 60 years.Methods:A retrospective analysis was performed for 150 SPK patients from January 1, 2013 to June 30, 2019. Based upon age, they were divided into three groups of ≥60 years ( n=21), 50-60 years ( n=44) and <50 years ( n=85). Clinical data of three groups were compared, including postoperative rejection, perioperative graft thrombosis, reoperative frequency, average hospitalization time and readmission ratio. And cardiocerebrovascular complications before/after-SPK, CMV viremia within 1 year post-SPK, fasting blood glucose, fasting C-peptide, fasting insulin level, HbA1c at 1 year post-SPK, glomerular filtration rate (eGFR) at 1 year post-SPK and survival rate of patient/graft were compared. Results:There were 21 cases in ≥60 years group, accounting for 14% of the total number of cases and the maximal age was 67 years. The proportion of preoperative cardiovascular events was 14.3%(3/21) in ≥60 years group, 34.1%(15/44) in 50-60 years group and 7.1%(6/85) in <50 years group. Statistical difference existed among three groups ( P=0.001). A pairwise comparison indicated that preoperative cardiovascular event in 50-60 years group was higher than that in <50-years group ( P=0.0006). The postoperative cardiovascular events in three groups were 4.8%, 4.5% and 2.4% respectively and there was no statistical difference ( P=0.537). The incidence of graft thrombosis in three groups was 2 cases (9.5%) in ≥60 years group, 1 case (2.3%) in 50-60 years group and 7 cases (8.2%) in <50 years group ( P=0.384). The proportion of reoperation in three groups was 14.3%, 18.3% and 18.8% respectively and there was no statistical difference ( P=0.889). The causes of death were cerebral hemorrhage ( n=2), myocardial infarction ( n=2) and tumor ( n=1); ≥ 60 years group ( n=1), 50-60 years group ( n=1) and <50 years group ( n=3). No significant difference existed among three groups ( P=0.842). There was no significant difference in average postoperative hospitalization time, readmission rate, postoperative rejection, postoperative 1-year CMV viremia, postoperative cerebrovascular events, postoperative 1-year fasting blood glucose, fasting C-peptide, fasting insulin level, HbA1c, postoperative 1-year eGFR or patient/graft survival rate among three groups. Conclusions:Through strict preoperative evaluations, SPK for patients aged over 60 years increases no operative risk and achieves the same outcome.
