FUNCTION AND SURVIVAL OF RENAL-ALLOGRAFTS FROM THE SAME DONOR TRANSPLANTED INTO KIDNEY-ONLY OR KIDNEY-PANCREAS RECIPIENTS

Background. The aim of this study was to assess whether kidney-pancrea s transplantation (KPT) compromises the prognosis of kidney transplant ation (KT), Methods. This study included 368 paired recipients who rec eived grafts from the same donor (184 KPT/184 RT), i.e., renal grafts with the same pretransplant functional and pathologic characteristics. Results. KPT recipients (KPR) were significantly younger and included fewer African-Americans (22% vs, 6%, P=0.0005) than recipients of kid ney alone (KR). During year 1 after transplant surgery, KPR were readm itted more often than KR (4.2+/-2 vs. 2.8+/-2, P<0.0001), The number o f acute rejections (AR) and the serum creatinine were not significantl y different in KR and KPR up to 3 years after transplant, After 44+/-2 9 months, 13% of KR and 17% of KPR died (NS), and 17% of KR and 16% of KPR lost their kidneys (NS), In KPR, reduced renal graft survival did not correlate with AR (P=0.44), but it correlated with: older donors, younger recipients, elevated serum creatinine at 6 months, pancreas l oss, and the number of episodes of acute graft dysfunction evaluated b y biopsy (multivariate analysis). By Cox, graft and patient survival w ere not significantly different in KR and KPR, However, the patient su rvival of KPR <40 years of age was lower than that of KR (P=0.02). Ren al biopsies (n=165) in 40 paired recipients showed no significant diff erences in AR, interstitial fibrosis, or vascular pathology, Conclusio ns. Renal graft function, structure, and survival are not different in KPR and KR, but the correlates of renal graft survival are different in these two groups of recipients.