An analysis of pancreas transplantation outcomes based on age groupings--an update of the UNOS database

Clin Transplant. 2014 Sep;28(9):990-4. doi: 10.1111/ctr.12407. Epub 2014 Jul 28.

Abstract

Introduction: Previously, increasing age has been a part of the exclusion criteria used when determining eligibility for a pancreas transplant. However, the analysis of pancreas transplantation outcomes based on age groupings has largely been based on single-center reports.

Methods: A UNOS database review of all adult pancreas and kidney-pancreas transplants between 1996 and 2012 was performed. Patients were divided into groups based on age categories: 18-29 (n = 1823), 30-39 (n = 7624), 40-49 (n = 7967), 50-59 (n = 3160), and ≥60 (n = 280). We compared survival outcomes and demographic variables between each age grouping.

Results: Of the 20 854 pancreas transplants, 3440 of the recipients were 50 yr of age or above. Graft survival was consistently the greatest in adults 40-49 yr of age. Graft survival was least in adults age 18-29 at one-, three-, and five-yr intervals. At 10- and 15-yr intervals, graft survival was the poorest in adults >60 yr old. Patient survival and age were found to be inversely proportional; as the patient population's age increased, survival decreased.

Conclusion: Pancreas transplants performed in patients of increasing age demonstrate decreased patient and graft survival when compared to pancreas transplants in patients <50 yr of age.

Keywords: age based outcomes; graft survival; pancreas transplantation; rejection; risk stratification.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aging / physiology*
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Graft Survival / physiology*
  • Humans
  • Kidney Transplantation* / statistics & numerical data
  • Male
  • Middle Aged
  • Pancreas Transplantation* / statistics & numerical data
  • Prognosis
  • Registries
  • Tissue Donors
  • Tissue and Organ Procurement
  • Young Adult