Impacto da função retardada do enxerto pancreático no transplante simultâneo pâncreas-rim

Detalhes bibliográficos
Autor(a) principal: Baitello, Marina [UNIFESP]
Data de Publicação: 2011
Outros Autores: 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]
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.
id UFSP_91d01f9d470d57e4efb1d1b8e48b4010
oai_identifier_str oai:repositorio.unifesp.br/:11600/6459
network_acronym_str UFSP
network_name_str Repositório Institucional da UNIFESP
repository_id_str 3465
spelling 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
collection 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
_version_ 1818602579317227520