PMID- 1543393
OWN - NLM
STAT- MEDLINE
DCOM- 19920408
LR  - 20190514
IS  - 0003-4932 (Print)
IS  - 1528-1140 (Electronic)
IS  - 0003-4932 (Linking)
VI  - 215
IP  - 3
DP  - 1992 Mar
TI  - Donor hyperglycemia as a minor risk factor and immunologic variables as major 
      risk factors for pancreas allograft loss in a multivariate analysis of a single 
      institution's experience.
PG  - 217-30
AB  - The impact of multiple donor and recipient variables on functional survival of 
      307 cadaveric pancreas allografts transplanted in 253 recipients at the authors' 
      institution between July 25, 1978 and September 4, 1990 was determined using the 
      Cox proportional hazards regression model. Relative risk of graft loss was 
      calculated for all cases as well as for technically successful (TS) ones. Factors 
      with an impact in descending order of significance for TS cases were 
      immunosuppression (RR = 3.9 for double-drug versus triple-drug maintenance, p 
      less than 0.0001); recipient category (RR = 2.4 for pancreas alone versus 
      simultaneous pancreas/kidney, p = 0.009); retransplantation (RR = 1.8 for 
      retransplants versus primary grafts, p = 0.007); donor hyperglycemia (RR = 1.7 
      for blood glucose greater than or equal to 200 versus less than 200 mg/dL, p = 
      0.02); human leukocyte antigen (HLA) matching (RR = 2.1 for poor versus a good 
      match, p = 0.04). A logistic regression analysis also was performed to determine 
      which factors predisposed to technical failure; none were identified. To make the 
      model as relevant as possible to their current program, the authors analyzed only 
      the bladder-drained cases (n = 221; 1984 to 1990). All patients received triple 
      therapy. Recipient category, retransplantation, donor hyperglycemia, and degree 
      of HLA matching remained as significant risk factors. Construction of estimated 
      survival curves showed that the results of retransplantation were significantly 
      improved, and the penalty incurred by using hyperglycemic donors was partially 
      ameliorated by using well-matched donors. Because preservation times up to 30 
      hours did not exert an adverse effect on outcome, an argument is made to share 
      pancreata between centers to achieve good matches.
FAU - Gores, P F
AU  - Gores PF
AD  - Department of Surgery, University of Minnesota, Minneapolis.
FAU - Gillingham, K J
AU  - Gillingham KJ
FAU - Dunn, D L
AU  - Dunn DL
FAU - Moudry-Munns, K C
AU  - Moudry-Munns KC
FAU - Najarian, J S
AU  - Najarian JS
FAU - Sutherland, D E
AU  - Sutherland DE
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Ann Surg
JT  - Annals of surgery
JID - 0372354
SB  - IM
MH  - Female
MH  - *Graft Survival
MH  - Histocompatibility
MH  - Humans
MH  - *Hyperglycemia
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Organ Preservation
MH  - *Pancreas Transplantation
MH  - Reoperation
MH  - Risk Factors
MH  - *Tissue Donors
PMC - PMC1242424
EDAT- 1992/03/01 00:00
MHDA- 1992/03/01 00:01
PMCR- 1992/03/01
CRDT- 1992/03/01 00:00
PHST- 1992/03/01 00:00 [pubmed]
PHST- 1992/03/01 00:01 [medline]
PHST- 1992/03/01 00:00 [entrez]
PHST- 1992/03/01 00:00 [pmc-release]
AID - 10.1097/00000658-199203000-00005 [doi]
PST - ppublish
SO  - Ann Surg. 1992 Mar;215(3):217-30. doi: 10.1097/00000658-199203000-00005.