Browsing by Author "Gonzalez, Adriano M."

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    Impact of Pancreatic Allograft Function on 1-Year Survival Rates After Simultaneous Pancreatic-Renal Transplant
    (Başkent Üniversitesi, 2008-12) Rangel, Érika B.; Medina-Pestana, José O.; Salzedas, Alcides; Sá, João R. de; Linhares, Marcelo M.; Gonzalez, Adriano M.; Melaragno, Cláudio S.
    Objectives: Simultaneous pancreatic-renal transplant is an effective treatment for insulin-dependent patients with chronic renal failure. We sought to identify the main influences on pancreatic and patient survival rates after simultaneous pancreas-kidney transplants. Patients and Methods: The 1-year patient and pancreas survival rates of 150 patients who had undergone simultaneous pancreas-kidney transplant were analyzed by the Cox proportional hazards regression model and the Kaplan-Meier method. Uni- and multivariate analyses were performed in terms of transplant-, recipient-, and donor-related risk factors. Results: At 1 year, patient and pancreatic allograft survival rates were 82% and 76.7%, respectively. Delayed graft function in the kidney (P = .001, HR 5.41), acute kidney rejection (P = .016, HR 3.36), and intra-abdominal infection (P < .0001, HR 4.15) were the main factors related to 1-year patient survival. Pancreatic allograft survival at 1 year was related to intra-abdominal infection (P < .0001, OR 12.83), vascular thrombosis (P = .002, OR 40.55), acute kidney rejection (P = .027, OR 3.06), donor sodium greater than 155 mEq/L (P = .02, OR 3.27), and dopamine administration exceeding 7.6 μg/kg/min (P = .046, OR 2.85). Conclusions: Delayed kidney allograft function and intra-abdominal infection had an important effect on both patient and pancreatic allograft survival rates.