Long-Term Pancreas Allograft Survival in Simultaneous Pancreas-Kidney Transplantation by Era

OBJECTIVE: To determine whether short-term improvement in pancreas graft survival with simultaneous pancreas-kidney (SPK) transplants translated into improved long-term survival, then to examine the implications of that determination. RESEARCH DESIGN AND METHODS: We analyzed data for 14,311 diabetic patients who received a first SPK transplant between October 1987 and November 2007, using Kaplan-Meier analysis for graft survival rates and Cox regression analysis for year-of-transplant effect. RESULTS: Overall, from 1995 to 2004, 5-year pancreas graft survival stayed about the same (70-71%). Limiting analysis to grafts that survived more than 1 year, 5-year survival from 1987 to 2004 ranged from 80 to 84%. With 1987-1989 as reference, the adjusted hazard ratio for graft failure by year of transplant increased to 1.49 (95% CI 0.97-2.30) in 2000-2004. CONCLUSIONS: Long-term pancreas graft survival has remained unchanged despite the dramatic decreases in technical failures and early acute rejection rates that have contributed to prolonged SPK graft survival.