Influence of duration of type 1 diabetes on long-term pancreatic transplant outcomes

J Hepatobiliary Pancreat Sci. 2019 Dec;26(12):583-592. doi: 10.1002/jhbp.677. Epub 2019 Nov 2.

Abstract

Background: There are no multicenter studies on the influence of diabetes duration on pancreatic transplant outcomes. Our study aimed to determine how type 1 diabetes duration influenced survival of pancreatic grafts.

Methods: The data of 8,139 patients who received pancreas transplants during 2006-2015 were extracted from the Scientific Registry of Transplant Recipients database. Patients were separated into two groups according to duration of diabetes: S group (diabetes ≤20 years) and L group (>20 years).

Results: Compared to S group, L group were older and prone to be male, to have higher body mass index, to receive pancreas after kidney transplantation (PAK), and to be White. Patient survival was not significantly different between the two groups, but pancreatic survival was better in the L group (hazard ratio 0.88; P = 0.012). Pancreatic survival of L group was better than S group in pancreas transplant alone and simultaneous pancreas-kidney transplantation (SPK). Graft survival was not significant different between the two groups in PAK. Diabetes duration was an independent predictor of graft survival in SPK patients (hazard ratio 0.86; P = 0.012).

Conclusions: Diabetes duration has no influence on patient survival. However, long duration of type 1 diabetes mellitus appears to be protective against pancreatic graft loss.

Keywords: Duration of diabetes; Outcome; Pancreas transplantation; Predictor; Type 1 diabetes mellitus.

MeSH terms

  • Diabetes Mellitus, Type 1 / mortality
  • Diabetes Mellitus, Type 1 / surgery*
  • Female
  • Graft Survival*
  • Humans
  • Male
  • Pancreas Transplantation*
  • Time Factors
  • Treatment Outcome