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The risk of progression to renal replacement after pancreas transplant alone (PTA) is a concern in patients with pre-transplant estimated glomerular filtration rate (eGFR) <70mL/min/1.73m2. This is a retrospective, single-center risk analysis of potential factors affecting renal function after PTA. Twenty-four patients, transplanted over a three-yr period, with functioning pancreatic grafts at the study's end point were included. High tacrolimus levels (>12mg/dL) at sixmonths post-transplant was the only independent risk factor identifying a substantial decline in native renal function by Cox regression analysis (HR=14.300, CI=1.271-160.907, p=0.031). The presence of severe pre-transplant proteinuria (urine Pr/Cr ≥100mg/mmol) marginally failed to reach significance (p=0.056). Low eGFR levels alone (≤45 and ≤40mL/min/1.73m2) at the time of transplant did not correlate with substantial decline in renal function. Our data suggest that PTA is a justifiable therapy for patients with hypoglycemia unawareness or other life-threatening diabetic complications, even in those with borderline renal function, provided that they do not suffer from severe proteinuria and appropriate monitoring and tailoring of immunosuppression is ensured. © 2012 John Wiley & Sons A/S.

Original publication

DOI

10.1111/j.1399-0012.2011.01534.x

Type

Journal article

Journal

Clinical Transplantation

Publication Date

01/05/2012

Volume

26

Pages

387 - 392