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Outcomes of simultaneous pancreas and kidney transplantation based on donor resuscitation.
American Journal of Transplantation ( IF 8.9 ) Pub Date : 2020-02-05 , DOI: 10.1111/ajt.15808
Franka Messner 1, 2 , Joanna W Etra 2 , Yifan Yu 2 , Allan B Massie 2, 3 , Kyle R Jackson 2 , Gerald Brandacher 2, 4 , Stefan Schneeberger 1 , Christian Margreiter 1 , Dorry L Segev 2, 3, 5
Affiliation  

It has been hypothesized that transplanting simultaneous pancreas kidney (SPK) grafts from donors with a history of cardiac arrest and cardiopulmonary resuscitation (CACPR) leads to inferior posttransplant outcomes due to organ hypoperfusion during cardiac arrest and mechanical trauma during resuscitation. Using Scientific Registry of Transplant Recipients data, we identified 13 095 SPK transplants from 2000-2018, of which 810 (6.2%) were from donors with a history of CACPR. After inverse probability of treatment weighting on donor and recipient characteristics, we found that 1-, 5-, and 10-year patient (CACPR: 96.4%, 89.9%, and 78.9%; non-CACPR: 96.3%, 88.9%, and 76.0%; P = .3), death-censored pancreas graft survival (CACPR: 89.3%, 82.7%, 75.0%; non-CACPR: 89.9%, 82.7%, 76.3%; P = .7), and death-censored kidney graft survival (CACPR: 97.0%, 89.5%, 78.2%; non-CACPR: 96.9.9%, 88.7%, 80.0%; P = .4) were comparable between the two groups. There were no differences in the risk of pancreatitis (CACPR: 2.9%, non-CACPR: 2.4%; weighted OR = 0.74 1.22 2.02 ; P = .4), anastomotic leak (CACPR: 1.6%, non-CACPR: 2.0%; weighted OR = 0.54 1.02 1.93 ; P > .9), or median length of hospital stay (CACPR: 8 days, non-CACPR: 9 days; P = .6) for recipients of CACPR vs non-CACPR donors. Our findings suggest that CACPR donors could be used to expand the SPK donor pool without compromising short- or long-term outcomes.

中文翻译:

基于供体复苏的同时胰腺和肾脏移植的结果。

据推测,从有心脏骤停和心肺复苏 (CACPR) 病史的供体移植胰肾 (SPK) 移植物会导致较差的移植后结果,原因是心脏骤停期间的器官灌注不足和复苏期间的机械创伤。使用移植接受者科学登记数据,我们确定了 2000-2018 年的 13095 例 SPK 移植,其中 810 例 (6.2%) 来自有 CACPR 病史的捐赠者。在对供体和受体特征进行治疗加权的逆概率后,我们发现 1 年、5 年和 10 年患者(CACPR:96.4%、89.9% 和 78.9%;非 CACPR:96.3%、88.9% 和76.0%;P = .3),死亡审查的胰腺移植物存活率(CACPR:89.3%、82.7%、75.0%;非 CACPR:89.9%、82.7%、76.3%;P = .7)和死亡审查移植肾存活率 (CACPR: 97.0%, 89.5%, 78.2%;非 CACPR:96.9.9%、88.7%、80.0%;P = .4) 两组之间具有可比性。胰腺炎(CACPR:2.9%,非 CACPR:2.4%;加权 OR = 0.74 1.22 2.02;P = .4)、吻合口漏(CACPR:1.6%,非 CACPR:2.0%;加权 OR = 0.54 1.02 1.93 ;P > .9)或中位住院时间(CACPR:8 天,非 CACPR:9 天;P = .6)对于 CACPR 接受者与非 CACPR 捐赠者。我们的研究结果表明,CACPR 捐助者可用于扩大 SPK 捐助者库,而不会影响短期或长期结果。.9),或 CACPR 接受者与非 CACPR 捐赠者的住院时间中位数(CACPR:8 天,非 CACPR:9 天;P = .6)。我们的研究结果表明,CACPR 捐助者可用于扩大 SPK 捐助者库,而不会影响短期或长期结果。.9),或 CACPR 接受者与非 CACPR 捐赠者的住院时间中位数(CACPR:8 天,非 CACPR:9 天;P = .6)。我们的研究结果表明,CACPR 捐助者可用于扩大 SPK 捐助者库,而不会影响短期或长期结果。
更新日期:2020-02-05
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