Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
dARK ID: | ark:/48912/00130000161tr |
Texto Completo: | http://dx.doi.org/10.1590/S0101-28002011000200010 http://repositorio.unifesp.br/handle/11600/6459 |
Resumo: | OBJECTIVE: Simultaneous pancreas-kidney transplantation is an effective treatment for patients with type 1 diabetes melli>tus and end-stage chronic kidney disease. Delayed pancreatic graft function is a common and multifactor condition with significant impact in short-term outcome of simultaneous pancreas-kidney transplantations. The aim of this study was to analyze the impact of pancreatic delayed pancreatic graft function on simultaneous pancreas-kidney transplantation. METHODS: Donor and recipient's demographic data, percentage of panel reactivity, acute rejection incidence, and patient and grafts survivals were retrospectively analyzed in 180 SPKT performed between 2002 and 2007. RESULTS: The incidence of pancreatic delayed pancreatic graft function was 11%. Donors older than 45 years had significant risk of pancreatic delayed pancreatic graft function (OR 2.26; p < 0,05). Patients with pancreatic delayed pancreatic graft function had higher rates of acute renal rejection (47 versus 24%; p < 0.05), altered fasting plasma glucose (25 versus 5%; p < 0.05) and mean glycated hemoglobin (5.8 versus 5.4%; p < 0.05), than patients without pancreatic delayed pancreatic graft function at the end of the first year of follow up. There were no significant differences between patients with and without pancreatic delayed pancreatic graft function regarding patient survival (95 versus 88.7%; p = 0.38), pancreatic graft survival (90 versus 85.6%; p = 0.59) and renal graft survival (90 versus 87.2%; p = 0.70), respectively at the sample period of time. CONCLUSION: Pancreatic delayed pancreatic graft function had no significant impact in the short-term outcome of simultaneous pancreas-kidney transplantations. Although delayed pancreatic graft function had no impact on 1-year pancreas graft survival, it contributed to early pancreas graft dysfunction, as assessed by enhanced insulin and oral anti-diabetic drugs requirements. |
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Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rimImpact of delayed pancreatic graft function in simultaneous pancreas-kidney transplantationKidney transplantationPancreas transplantationGraft rejectionSurvival analysisLogistic modelsTransplante de rimTransplante de pâncreasRejeição de enxertoAnálise de sobrevidaModelos logísticosOBJECTIVE: Simultaneous pancreas-kidney transplantation is an effective treatment for patients with type 1 diabetes melli>tus and end-stage chronic kidney disease. Delayed pancreatic graft function is a common and multifactor condition with significant impact in short-term outcome of simultaneous pancreas-kidney transplantations. The aim of this study was to analyze the impact of pancreatic delayed pancreatic graft function on simultaneous pancreas-kidney transplantation. METHODS: Donor and recipient's demographic data, percentage of panel reactivity, acute rejection incidence, and patient and grafts survivals were retrospectively analyzed in 180 SPKT performed between 2002 and 2007. RESULTS: The incidence of pancreatic delayed pancreatic graft function was 11%. Donors older than 45 years had significant risk of pancreatic delayed pancreatic graft function (OR 2.26; p < 0,05). Patients with pancreatic delayed pancreatic graft function had higher rates of acute renal rejection (47 versus 24%; p < 0.05), altered fasting plasma glucose (25 versus 5%; p < 0.05) and mean glycated hemoglobin (5.8 versus 5.4%; p < 0.05), than patients without pancreatic delayed pancreatic graft function at the end of the first year of follow up. There were no significant differences between patients with and without pancreatic delayed pancreatic graft function regarding patient survival (95 versus 88.7%; p = 0.38), pancreatic graft survival (90 versus 85.6%; p = 0.59) and renal graft survival (90 versus 87.2%; p = 0.70), respectively at the sample period of time. CONCLUSION: Pancreatic delayed pancreatic graft function had no significant impact in the short-term outcome of simultaneous pancreas-kidney transplantations. Although delayed pancreatic graft function had no impact on 1-year pancreas graft survival, it contributed to early pancreas graft dysfunction, as assessed by enhanced insulin and oral anti-diabetic drugs requirements.OBJETIVO: O transplante pâncreas-rim é efetivo para pacientes com doença renal crônica terminal e diabetes mellitus insulino-dependente. A função retardada do enxerto pancreático é condição frequente exercendo impacto significativo nos resultados em curto prazo dos transplantes pâncreas-rim. O objetivo foi analisar o impacto da função retardada do enxerto pancreático no transplante pâncreas-rim. MÉTODOS: Análise retrospectiva de 180 receptores de transplante pâncreas-rim, incluindo dados demográficos dos doadores e dos receptores, a reatividade contra painel, a incidência de rejeição aguda e as sobrevidas do paciente e dos enxertos pancreático e renal. RESULTADOS: A incidência de função retardada do enxerto pancreático foi 11%. A idade do receptor superior a 45 anos apresentou associação com o risco de desenvolvimento de função retardada do enxerto pancreático (Razão de chances 2,26; p < 0,05). Os pacientes com função retardada do enxerto pancreático apresentaram maior incidência de rejeição aguda renal (47 versus 24%; p < 0,05), glicemia de jejum alterada (25 versus 5%; p < 0,05) e média de hemoglobina glicada (5,8 versus 5,4%; p < 0,05) ao final do primeiro ano de acompanhamento em relação aos pacientes sem função retardada do enxerto pancreático. Não houve diferenças estatisticamente significativas entre os grupos de pacientes com e sem função retardada do enxerto pancreático quanto à sobrevida do paciente (95 versus 88,7%; p = 0,38), do enxerto pancreático (90 versus 85,6%; p = 0,59) e do enxerto renal (90 versus 87,2%; p = 0,70), respectivamente, nesse mesmo período. CONCLUSÃO: A função retardada do enxerto pancreático não exerceu impacto significativo nos resultados em curto prazo dos transplantes pâncreas-rim desta casuística. Embora a função retardada do enxerto pancreático não tenha influenciado a sobrevida do enxerto pancreático ao final do primeiro ano após o transplante, contribuiu para a disfunção pancreática precoce, indicando maior necessidade de uso de insulina e hipoglicemiantes orais.Universidade Federal de São Paulo (UNIFESP) Departamento de MedicinaUNIFESP Departamento de CirurgiaUNIFESP, Depto. de MedicinaUNIFESP, Depto. de CirurgiaSciELOSociedade Brasileira de NefrologiaUniversidade Federal de São Paulo (UNIFESP)Baitello, Marina [UNIFESP]Galante, Nelson Zocoler [UNIFESP]Coutinho, Luciano de Souza [UNIFESP]Rangel, Erika Bevilaqua [UNIFESP]Melaragno, Cláudio Santiago [UNIFESP]Gonzalez, Adriano Miziara [UNIFESP]Pestana, Jose Osmar Medina [UNIFESP]2015-06-14T13:43:05Z2015-06-14T13:43:05Z2011-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion180-188application/pdfhttp://dx.doi.org/10.1590/S0101-28002011000200010Jornal Brasileiro de Nefrologia. Sociedade Brasileira de Nefrologia, v. 33, n. 2, p. 180-188, 2011.10.1590/S0101-28002011000200010S0101-28002011000200010.pdf0101-2800S0101-28002011000200010http://repositorio.unifesp.br/handle/11600/6459ark:/48912/00130000161trporJornal Brasileiro de Nefrologiainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-29T18:20:08Zoai:repositorio.unifesp.br/:11600/6459Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-12-11T20:58:49.698640Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim Impact of delayed pancreatic graft function in simultaneous pancreas-kidney transplantation |
title |
Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim |
spellingShingle |
Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim Baitello, Marina [UNIFESP] Kidney transplantation Pancreas transplantation Graft rejection Survival analysis Logistic models Transplante de rim Transplante de pâncreas Rejeição de enxerto Análise de sobrevida Modelos logísticos |
title_short |
Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim |
title_full |
Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim |
title_fullStr |
Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim |
title_full_unstemmed |
Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim |
title_sort |
Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim |
author |
Baitello, Marina [UNIFESP] |
author_facet |
Baitello, Marina [UNIFESP] Galante, Nelson Zocoler [UNIFESP] Coutinho, Luciano de Souza [UNIFESP] Rangel, Erika Bevilaqua [UNIFESP] Melaragno, Cláudio Santiago [UNIFESP] Gonzalez, Adriano Miziara [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] |
author_role |
author |
author2 |
Galante, Nelson Zocoler [UNIFESP] Coutinho, Luciano de Souza [UNIFESP] Rangel, Erika Bevilaqua [UNIFESP] Melaragno, Cláudio Santiago [UNIFESP] Gonzalez, Adriano Miziara [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Baitello, Marina [UNIFESP] Galante, Nelson Zocoler [UNIFESP] Coutinho, Luciano de Souza [UNIFESP] Rangel, Erika Bevilaqua [UNIFESP] Melaragno, Cláudio Santiago [UNIFESP] Gonzalez, Adriano Miziara [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] |
dc.subject.por.fl_str_mv |
Kidney transplantation Pancreas transplantation Graft rejection Survival analysis Logistic models Transplante de rim Transplante de pâncreas Rejeição de enxerto Análise de sobrevida Modelos logísticos |
topic |
Kidney transplantation Pancreas transplantation Graft rejection Survival analysis Logistic models Transplante de rim Transplante de pâncreas Rejeição de enxerto Análise de sobrevida Modelos logísticos |
description |
OBJECTIVE: Simultaneous pancreas-kidney transplantation is an effective treatment for patients with type 1 diabetes melli>tus and end-stage chronic kidney disease. Delayed pancreatic graft function is a common and multifactor condition with significant impact in short-term outcome of simultaneous pancreas-kidney transplantations. The aim of this study was to analyze the impact of pancreatic delayed pancreatic graft function on simultaneous pancreas-kidney transplantation. METHODS: Donor and recipient's demographic data, percentage of panel reactivity, acute rejection incidence, and patient and grafts survivals were retrospectively analyzed in 180 SPKT performed between 2002 and 2007. RESULTS: The incidence of pancreatic delayed pancreatic graft function was 11%. Donors older than 45 years had significant risk of pancreatic delayed pancreatic graft function (OR 2.26; p < 0,05). Patients with pancreatic delayed pancreatic graft function had higher rates of acute renal rejection (47 versus 24%; p < 0.05), altered fasting plasma glucose (25 versus 5%; p < 0.05) and mean glycated hemoglobin (5.8 versus 5.4%; p < 0.05), than patients without pancreatic delayed pancreatic graft function at the end of the first year of follow up. There were no significant differences between patients with and without pancreatic delayed pancreatic graft function regarding patient survival (95 versus 88.7%; p = 0.38), pancreatic graft survival (90 versus 85.6%; p = 0.59) and renal graft survival (90 versus 87.2%; p = 0.70), respectively at the sample period of time. CONCLUSION: Pancreatic delayed pancreatic graft function had no significant impact in the short-term outcome of simultaneous pancreas-kidney transplantations. Although delayed pancreatic graft function had no impact on 1-year pancreas graft survival, it contributed to early pancreas graft dysfunction, as assessed by enhanced insulin and oral anti-diabetic drugs requirements. |
publishDate |
2011 |
dc.date.none.fl_str_mv |
2011-06-01 2015-06-14T13:43:05Z 2015-06-14T13:43:05Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0101-28002011000200010 Jornal Brasileiro de Nefrologia. Sociedade Brasileira de Nefrologia, v. 33, n. 2, p. 180-188, 2011. 10.1590/S0101-28002011000200010 S0101-28002011000200010.pdf 0101-2800 S0101-28002011000200010 http://repositorio.unifesp.br/handle/11600/6459 |
dc.identifier.dark.fl_str_mv |
ark:/48912/00130000161tr |
url |
http://dx.doi.org/10.1590/S0101-28002011000200010 http://repositorio.unifesp.br/handle/11600/6459 |
identifier_str_mv |
Jornal Brasileiro de Nefrologia. Sociedade Brasileira de Nefrologia, v. 33, n. 2, p. 180-188, 2011. 10.1590/S0101-28002011000200010 S0101-28002011000200010.pdf 0101-2800 S0101-28002011000200010 ark:/48912/00130000161tr |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
Jornal Brasileiro de Nefrologia |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
180-188 application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1818602579317227520 |