RENAL-ALLOGRAFT FAILURE AFTER SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION - UNIVARIATE AND MULTIVARIATE ANALYSES OF DONOR AND RECIPIENT RISK-FACTORS

Although donor and recipient risk factors for renal allograft failure are well known after kidney transplantation, they are less well define d after simultaneous pancreas-kidney transplantation. The purpose of t his study is to evaluate the impact of donor and recipient risk factor s on the outcome of the renal allograft in simultaneous pancreas-kidne y recipients. Simultaneous pancreas-kidney transplant performed betwee n 4/88 and 6/94 were reviewed (n=61) and univariate (Kaplan-Meier) and multivariate (Cox regression) analyses of factors which affect kidney graft survival were performed. Twelve donor and eleven pre- and post- transplant recipient risk factors were evaluated. Overall kidney allog raft survival rates at 1, 2 and 5 yr were 81%, 76% and 66%. Donor age greater than or equal to 40 yr (RR=2.3), donor female gender (RR=3.5), donor admission to pronouncement of brain death greater than or equal to 48 h (RR=3), the occurrence of surgical complications (RR=2.1), an d serum greater than or equal to 2 mg/dl on post-transplant day (RR=1. 9) were independently associated with an increased hazard of graft fai lure. With the exception of length of donor admission, all of these fa ctors were also shown to predict the risk of renal graft failure by un ivariate analysis. In conclusion, we have identified donor and recipie nt risk factors which independently predict the risk of renal graft fa ilure after simultaneous pancreas-kidney transplantation. Whether the differences between our center-specific risk factors and those obtaine d from renal transplant registry data are true differences or simply r eflect sampling error is unclear.