Background. The increased popularity of pancreas transplants has led to an
increased number potential candidates for retransplants after the initial g
raft has been lost to technical failure or rejection. We studied a group of
recipients who underwent pancreas transplants at a single center to determ
ine whether retransplant recipients were at higher risk of complications.
Methods. Between June 1, 1994, and Dec 31, 1997, a total of 213 pancreas tr
ansplants were performed at the University of Minnesota. Of these, 187 were
primary transplants and 26 were retransplants. Demographically, the two gr
oups were not significantly different. We analyzed and compared the two gro
ups with respeect to incidence of surgical complications, graft survival ra
tes, and patient survival rates.
Results. Surgical complications such as bleeding and vascular thrombosis we
re slightly more common after retransplants, but this trend did not quite r
each statistical significance. Infectious complications and leaks were equi
valent between the two groups. The incidence of acute rejection was higher
after retransplants (P = .02). At 3 years postransplant, patient survival w
as no different between the two 97 groups, but pancreas graft survival was
lower after retransplants (P = .08). The incidence of early graft loss (by
6 months posttransplant) was significantly higher in retransplant recipient
s (27% vs 14%, P = .04).
Conclusions, Pancreas retransplants can be performed with a minimal increas
e in surgical complications. However, graft survival after retransplants is
slightly inferior to that after primary transplants, probably for both imm
unologic and nonimmunologic reasons. Retransplants can be offered Co suitab
le candidates, but they may require more aggressive monitoring for rejectio
n.