Evaluation of Pancreatic Re-transplantation Outcomes
Date
2023-12
Authors
Sharma, Grace
Yallapragada, Vinay
Journal Title
Journal ISSN
Volume Title
Publisher
George Mason University
Abstract
Background
In this literature review, we will cover details of prior research. This review includes studies published after 2012. There is extremely limited information available about the outcomes of pancreas retransplants. Most studies in this field are single-center reports with small datasets. This literature review can be divided into three main areas:
1. Analysis of graft survival in different forms of pancreas transplants
2. Analysis of patient survival in different forms of pancreas transplants
3. Review of recommendations to consider pancreas retransplants for patients
Several studies have identified the graft survival rates of retransplant patients and compared them with graft survival rates for other pancreas transplant patients. In [7], authors compared the graft survival between 187 primary transplant and 26 retransplant patients, noting that graft survival rates were lower amongst retransplants than primary transplants. In 2018, Gasteiger et al. [4] concluded that graft survival in first-time retransplant patients was similar to graft survival amongst patients that received more than one retransplant. In [1], Hollinger determined that graft survival was similar amongst patients who received an early retransplant and a delayed retransplant. Most studies analyzing graft survival rates in pancreas retransplants are single-center reports studying less than 50 patients each. In 2015, Siskind et al. [6] reviewed more than a thousand retransplants in a larger database, UNOS; the authors determined that graft survival in retransplant patients was significantly lower than primary transplant patients.
Most studies determining graft survival rates of retransplant patients also studied patient survival rates. In [2], the authors conducted an in-depth analysis of retransplants done after 2003 and determined that there was no significant difference between the patient survival rates of primary transplant and retransplant patients. In [7], the authors concluded that patient survival was not different for primary transplant patients and retransplant patients. The analysis on the UNOS database revealed that patient survival was greater in the retransplant group than the primary transplant group [6].
Most work in this field has concluded by supporting pancreas retransplants as a viable option for patients. In [5], the authors state that retransplants are feasible and that it should be considered for diabetic patients who have lost their first pancreas. In [3], where the authors analyzed 18 retransplant patients, the study concluded by determining that retransplants are a safe and effective procedure. In [7], the authors had determined that retransplants had lower graft survival than primary transplants yet concluded that it can be offered to diabetic patients. However, in [6], the authors analyzed over 1,000 retransplants and concluded that retransplants should not be considered for all patients.