Recipient age and outcome after pancreas transplantation: a retrospective dual‐center analysis

• Published in: Transplant international Vol. 34; no. 4; pp. 657 - 668
• Main Authors: Messner, Franka, Leemkuil, Marjolein, Yu, Yifan, Massie, Allan B., Krendl, Felix J., Benjamens, Stan, Bösmüller, Claudia, Weissenbacher, Annemarie, Schneeberger, Stefan, Pol, Robert A., Margreiter, Christian
• Format: Journal Article
• Language: English
• Published: Switzerland Blackwell Publishing Ltd 01.04.2021; John Wiley and Sons Inc
• Subjects: Age; Complications; Diabetes mellitus; donor age; Graft rejection; Graft Rejection - epidemiology; Graft Survival; Humans; Kidney Transplantation; Kidney transplants; Kidneys; Middle Aged; Original; Pancreas; Pancreas Transplantation; postoperative complications; recipient age; Retrospective Studies; Risk assessment; simultaneous pancreas kidney transplantation; Survival; Tissue Donors; Transplantation; Transplants; Transplants & implants; Treatment Outcome; recipient age; postoperative complications; simultaneous pancreas kidney transplantation; donor age; survival
• ISSN: 0934-0874; 1432-2277; 1432-2277
• DOI: 10.1111/tri.13845

With a later onset of diabetes complications and thus increasing age of transplant candidates, many centers have extended upper age limits for pancreas transplantation. This study investigates the effect of recipient and donor age on outcomes after pancreas transplantation.We retrospectively analyzed 565 pancreas transplants performed at two Eurotransplant centers. The cohort was split at a recipient and donor age of 50 and 40 years, respectively. Median recipient age in old patients (≥50 years; 27.2%) was 54 years and 40 years in young patients (<50 years). Compared to young recipients, old recipients had an inferior patient survival rate (≥50: 5yr, 82.8%; 10yr, 65.6%; <50: 5yr, 93.3%; 10yr, 82.0%; P < 0.0001). Old recipients demonstrated comparable death‐censored pancreas (≥50: 1yr, 80.6%; 5yr, 70.2%; <50: 1yr, 87.3%; 5yr, 77.8%; P = 0.35) and kidney graft survival (≥50: 1yr, 97.4%; 5yr, 90.6%; <50: 1yr, 97.8%; 5yr, 90.2%; P = 0.53) compared to young recipients. Besides a lower rate of kidney rejection, similar relative risks for postoperative complications were detected in old and young patients. This study shows that despite an increased mortality in old recipients, excellent graft survival can be achieved similar to that of young patients. Age alone should not exclude patients from receiving a pancreas transplant.