SPK Pancreas Graft Function
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I P T R / UNOS SPK Pancreas Graft Function USA Primary DD Pancreas Transplants, 10/1/1987 –12/31/2010 3/11 0 24 48 72 96 120 144 168 192 216 240 0 20 40 60 80 100 1987-93 1994-97 1998-01 2002-05 2006-10 Months Posttransplant %
description
SPK Pancreas Graft Function. USA Primary DD Pancreas Transplants, 10/1/1987 – 12/31/2010. 3/11. SPK Pancreas Graft Function. USA Primary DD Pancreas Transplants, 10/1/1987 – 12/31/2010. 3/11. SPK Kidney Graft Function. USA Primary DD Pancreas Transplants, 10/1/1987 – 12/31/2010. 3/11. - PowerPoint PPT Presentation
Transcript of SPK Pancreas Graft Function
IPTR /UNOS
SPK Pancreas Graft FunctionUSA Primary DD Pancreas Transplants, 10/1/1987 –12/31/2010
3/11
0 24 48 72 96 120 144 168 192 216 2400
20
40
60
80
1001987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
IPTR /UNOS
SPK Pancreas Graft FunctionUSA Primary DD Pancreas Transplants, 10/1/1987 – 12/31/2010
3/11
0 24 48 72 96 120 144 168 192 2160
20
40
60
80
100
1987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
IPTR /UNOS
SPK Kidney Graft FunctionUSA Primary DD Pancreas Transplants, 10/1/1987 –12/31/2010
3/11
0 24 48 72 96 120 144 168 192 216 2400
20
40
60
80
1001987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
IPTR /UNOS
SPK Kidney Graft FunctionUSA Primary DD Pancreas Transplants, 10/1/1987 –12/31/2010
3/11
0 24 48 72 96 120 144 168 192 216 2400
20
40
60
80
1001987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
IPTR /UNOS
0 24 48 72 96 120 144 168 192 216 2400
20
40
60
80
100 1987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
PAK Pancreas Graft FunctionUSA Primary DD Pancreas Transplants, 10/1/1987 –12/31/2010
3/11
IPTR /UNOS
0 24 48 72 96 120 144 168 192 216 2400
20
40
60
80
100 1987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
Re-PAK Pancreas Graft FunctionUSA Second DD Pancreas Transplants, 10/1/1987 –12/31/2010
3/11
IPTR /UNOS
0 24 48 72 96 120 144 168 192 2160
20
40
60
80
100 1987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
PAK Pancreas Graft FunctionUSA Primary DD Pancreas Transplants, 1/1/1988 –12/31/2009
3/11
IPTR /UNOS0 24 48 72 96 120 144 168 192 216
0
20
40
60
80
100
1987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
PTA Pancreas Graft FunctionUSA Primary DD Pancreas Transplants, 10/1/1987 – 12/31/2010
3/11
IPTR /UNOS
PTA Pancreas Graft FunctionUSA DD Primary Pancreas Transplants, 10/1/1987 – 12/31/2010
3/11
0 24 48 72 96 120 144 168 192 2160
20
40
60
80
100
1987-931994-971998-012002-052006-10
Months Posttransplant
%
IPTR /UNOS
0 24 48 72 96 120 144 1680
20
40
60
80 1987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
Kidney Transplants after PTAUSA Primary DD Pancreas Transplants, 10/1/1987 – 12/31/2010
3/11
IPTR /UNOS
0 12 24 36 48 60 72 84 96 108 1200
20
40
60
80 1987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
ReTx Rate after Primary PAKUSA Primary DD Pancreas Transplants, 10/1/1987 – 12/31/2010
3/11
IPTR /UNOS
0 12 24 36 48 60 72 84 96 108 1200
20
40
60
801987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
ReTx Rate after Primary PTAUSA Primary DD Pancreas Transplants, 10/1/1987 – 12/31/2010
3/11
IPTR /UNOS
0 12 24 36 48 60 72 84 96 108 1200
5
10
15
201987-93
1994-97
1998-01
2002-05
2006-10
Months Posttransplant
%
ReTx Rate after Primary SPKUSA Primary DD Pancreas Transplants, 10/1/1987 – 12/31/2010
3/11
IPTR /UNOS
1-Year Unadjusted Patient SurvivalUSA Primary DD Pancreas Transplants, 1/1/1988 – 12/31/2010
3/11
1988
/89
1990
/91
1992
/93
1994
/95
1996
/97
1998
/99
2000
/01
2002
/03
2004
/05
2006
/07
2008
/0960
70
80
90
100
PAKPTASPK
%
IPTR /UNOS
5-Year Unadjusted Patient SurvivalUSA Primary DD Pancreas Transplants, 1 /1/1988 – 12/31/2009
3/10
1988
/89
1990
/91
1992
/93
1994
/95
1996
/97
1998
/99
2000
/01
2002
/03
2004
/05
2006
/07
2008
/0960
70
80
90
100
PAKPTASPK
%
IPTR /UNOS
10-Year Unadjusted Patient SurvivalUSA DD Primary Pancreas Transplants, 1 /1/1988 – 12/31/2009
3/10
1988
/89
1990/9
1
1992/93
1994/95
1996/9
7
1998
/99
2000/01
2002/03
2004
/05
2006/07
2009/09
30405060708090
100
PAKPTASPK
%
IPTR /UNOS
1-Year Pancreas/Kidney Graft FunctionUSA Primary DD Pancreas Transplants, 10/1/1988 – 12/31/2010
2/11
1988
/89
1990
/91
1992
/93
1994
/94
1996
/97
1998
/99
2000
/01
2002
/03
2004
/05
2006
/07
2008
/0920
40
60
80
100
PAKPTASPK Px
%
IPTR /UNOS
5-Year Pancreas/Kidney Graft FunctionUSA DD Primary Pancreas Transplants, 1/1/1988 – 12/31/2010
3/11
1988
/89
1990
/91
1992
/93
1994
/95
1996
/97
1998
/99
2000
/01
2002
/03
2004
/05
2006
/07
2008
/090
102030405060708090
PAKPTASPK PxSPK Kd
%
IPTR /UNOS
10-Year Pancreas/Kidney Graft FunctionUSA Primary DD Pancreas Transplants, 1/1/1988 – 12/31/2010
3/11
1988/89
1990/91
1992/93
1994
/95
1996/9
7
1998
/99
2000/01
2002
/03
2004/05
2006/07
2008/09
01020304050607080
PAKPTASPK Px
%
IPTR /UNOS
Early Technical Pancreas Graft FailuresUSA DD Primary Pancreas Transplants, 1/1/1988 – 12/31/2010
3/11
1988
/89
1990
/91
1992
/93
1994
/95
1996
/97
1998
/99
2000
/01
2002
/03
2004
/05
2006
/07
2008
/090
10
20
30
PAKPTASPK
%
IPTR /UNOS
Early Technical Pancreas Graft FailuresUSA DD Primary Pancreas Transplants, 1/1/1988 – 12/31/2010
3/11
1987-93 1994-97 1998-01 2002-05 2006-100
2
4
6
8
10
12
14
16
18
PAKPTASPK
IPTR /UNOS
1 Year Immunological Pancreas Graft FailuresUSA DD Primary Pancreas Transplants, 1/1/1988 – 12/31/2010
3/11
1987-93 1994-97 1998-01 2002-05 2006-100
5
10
15
20
25
30
35
PAKPTASPK
IPTR /UNOS
1-Year Immunological Graft LossUSA DD Primary TS Pancreas Transplants, 1/1/1988 – 12/31/2010
3/11
1988
/89
1990
/91
1992
/93
1994
/95
1996
/97
1998
/99
2000
/01
2002
/03
2004
/05
2006
/07
2008
/0905
1015202530354045
PAKPTASPK
%
IPTR /UNOS
5-Year Immunological Graft LossUSA DD Primary TS Pancreas Transplants, 1/1/1988 – 12/31/2009
3/10
1988
/89
1990
/91
1992
/93
1994
/95
1996
/97
1998
/99
2000
/01
2002
/03
2004
/05
2006
/07
2008
/090
1020304050607080
PAKPTASPK
%
IPTR /UNOS
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
BD
ED
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
BD
ED
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
0
5
10
15
20
25
30
BD
ED
%
SPK PAK
Early Technical Pancreas Graft FailuresUSA DD Primary Pancreas Transplants, 1/1/1988 – 12/31/2009
3/10
PTA
Transplant Year
IPTR /UNOS
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
20
40
60
80
100
BDED
%
1-Year Pancreas Graft FunctionUSA DD Primary Pancreas Transplants, 1/1/1988 – 12/31/2010
3/11
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
BDED
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
BDED
SPK PAK PTA
Transplant Year
IPTR /UNOS
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
BDED
1-Year Immunological Pancreas Graft Loss RateUSA DD Primary TS Pancreas Transplants, 1/1/1988 – 12/31/2009
3/10
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
0
5
10
15
20
25
30
35
40BD
ED
%
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
BD
ED
SPK PAK PTA
Transplant Year
IPTR /UNOS
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/
BD
ED
5-Year Pancreas Graft FunctionUSA DD Primary Pancreas Transplants, 1/1/1988 – 12/31/2009
2/09
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/09
0
20
40
60
80
BD
ED
%
1988/89
1990/91
1992/93
1994/95
1996/97
1998/99
2000/01
2002/03
2004/05
2006/07
2008/
BDEDSPK
PAK PTA
IPTR /UNOS
0 6 12 18 24 30 3660
70
80
90
100
Months Posttransplant
%
Patient SurvivalUSA Primary DD Pancreas Transplants 1/1/2006 – 12/31/2010
Category n1Yr Surv.PTA 43396.4% PAK 80096.0% SPK 4,12995.8%
3/11
IPTR /UNOS
0 6 12 18 24 30 3660
65
70
75
80
85
90
95
100
Months Posttransplant
%
PAK Patient Survival by Kidney Donor TypeUSA DD Primary Pancreas Transplants 1/1/2005 – 12/31/2009
Kidney Dnr n 1Yr Surv. LD 672 97.2% DD 264 95.8%
p < 0.01
3/10
IPTR /UNOS
0 - 3 3 - 12 >120
5
10
15
20
25
30
35
Major Causes of Patient Death
0-3 4-12 >12
CCV
Infection
Bleeding
Malignancy
USA Primary DD Pancreas Transplants 1/1/2005 – 12/31/2009
SPK
0 - 6 7 - 12 >120-3 3-12 > 12 0-3 3-12 > 12 0-3 3-12 > 12
PAK PTA%
Months Posttransplant
3/10
IPTR /UNOS
0 6 12 18 24 30 360
102030405060708090
100
Months Posttransplant
%
Pancreas Graft FunctionUSA DD Primary Pancreas Transplants 1/1/2006 – 12/31/2010
Cat. n 1Yr Fxn SPK 4,122 88.4%PAK 798 82.6% PTA 433 79.9% p < 0.0001
3/11
DwFx Pancreas censored
IPTR /UNOS
0 6 12 18 24 30 360
20
40
60
80
100
Months Posttransplant
%
SPK Pancreas Graft Fxn by Donor TypeUSA DD Primary Pancreas Transplants 1/1/2005 – 12/31/2009
Donor n 1Yr Surv. Non-Hrt-Dnr 116 89.0%Standard 4,030 84.9%
p = 0.28
3/10
IPTR /UNOS
Pancreas Graft FunctionUSA DD Primary Pancreas Transplants 1/1/2005 – 12/31/2010
3/11
0 6 12 18 24 30 360
20
40
60
80
100
PAKPTASPK
Months Posttransplant
%
Cat. n 1Yr Fxn SPK 4,122 85.5%PAK 798 79.9% PTA 433 77.8% p < 0.0001
IPTR /UNOS
Pancreas Graft Function
Anti-T-Cell Therapy & TAC & MMF
0 6 12 18 24 30 360
102030405060708090
100
Months Posttransplant
%USA DD Primary Pancreas Transplants 1/1/2005 – 12/31/2009
Cat. n 1Yr Fxn PAK 544 81.3% PTA 271 85.6% SPK 2,737 86.3%
3/10
IPTR /UNOS
Pancreas Graft Function
Anti-T-Cell Therapy & Sirolimus based Protocol
0 6 12 18 24 30 360
102030405060708090
100
Months Posttransplant
%
USA DD Primary Pancreas Transplants 1/1/2005 – 12/31/2009
Cat. n 1Yr Fxn PAK 95 89.3% PTA 87 90.2% SPK 407 89.6%
3/10
IPTR /UNOS
0 - 2 3 - 11 >120
10
20
30
40
50
60
70
Major Causes of Px Graft Failure
0 - 3 4 - 12 >12
PmyNonFX
Partial Fx
Tech Flr
Acute Rej
Chron Rej
DWF Px
USA Primary DD Pancreas Transplants 1/1/2005 – 12/31/2009
SPK
0 - 3 4 - 12 >120-<3 3-<12 ≥ 12 0-<3 3-<12 ≥ 12 0-<3 3-<12 ≥12
PAK PTA
%
Months Posttransplant
3/09
IPTR /UNOS
SPK PAK PTA0
5
10
15
BD ED
%
Early Technical Failure RateUSA Primary DD Pancreas Transplants 1/1/2006 – 12/31/2010
* P = 0.01
*
IPTR /UNOS
Reasons for Early Technical FailuresUSA Primary DD Pancreas Transplants 1/1/2005 – 12/31/2009
3/10
SPK PAK PTA
BD ED p BD ED p BD ED p
Gft.Thmb 3.3% 5.6% 0.06 5.5% 8.6% 0.24 6.1% 7.6% 0.62
Infection 0.6% 0.5% 0.89 0.0% 0.8% 0.32 1.0% 0.3% 0.30
Pxitis 0.6% 0.5% 0.83 2.4% 0.3% 0.02 2.0% 0.0% 0.05
Anas.Leak 0.0% 0.4% 0.22 0.0% 0.5% 0.42 0.0% 0.3% 0.60
Bleed 0.0% 0.2% 0.40 0.0% 0.3% 0.57 0.0% 0.8% 0.36
IPTR /UNOS
Early Technical FailuresUSA Primary DD ED Pancreas Transplants 1/1/2005 – 12/31/2009
3/10
Systemic Portal p
SPK 6.9% 7.1% 0.86
PAK 9.2% 14.6% 0.06
PTA 7.9% 13.7% 0.16
IPTR /UNOS
0 6 12 18 24 30 360
5
10
15
20
25
30
Months Posttransplant
%
Immunological Pancreas Graft LossUSA Primary TS DD Pancreas Transplants 1/1/2005 – 12/31/2009
p = 0.0001Category n 1Yr LossPTA 413 6.0%PAK 811 5.5% SPK 3,687 2.1%
3/10
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