Bootcongres

Introduction Pancreas graft outcome reported by different transplantation centers is sometimes difficult to compare due to a difference in definitions of pancreas graft failure. No consensus exists on reporting whether graft failure is death-censored or –uncensored, nor whether the use of oral anti-hyperglycemic agents or raised glucose concentrations or HbA1c should be considered as graft failure. We aimed to compare pancreas graft outcome based on either return of insulin therapy (INS) or a based on the definition defined by the Pancreas Transplant Committee (PTC) of the OPTN. According to this definition of the OPTN, persistent HbA1c >6.3%, fasting glucose >7.00 mmol/l and/or insulin use were considered graft failure.. METHODS All pancreas transplants performed in our center from 1.1.1984 till 31.12.2012 were analyzed. For statistical survival analysis Kaplan-Meier survival curves were per-formed using both definitions. Results In the study period a total of 349 consecutive pancreas transplantations were performed, of which 325 (93%) simultaneous pancreas kidney (SPK), 21 (6%) pancreas after kidney (PAK) and 3 (1%) pancreas transplant alone (PTA) transplants. Graft survival at 1, 5, and 10-years differed between INS and OPTN definitions 85% vs. 84%, 79% vs. 76%, 75% vs. 71%, respectively. When comparing the two different definitions at 15-years of follow-up, a difference of even 10% in graft survival was observed (73% vs. 63%). Conclusion Different definitions of graft survival lead to significant differences in outcome after transplantation. A worldwide consensus should be reached on how to exactly define post-transplantation pancreas graft survival.