Pretransplant coronary artery disease associated with worse clinical outcomes in pancreas transplantation

Richard Mangus, John Powelson, Sandra B. Kinsella, Damond T. Farar, Cristina A. Creal, Jonathan A. Fridell

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Coronary artery disease (CAD) is common in patients with type I diabetes and may be associated with worse outcomes in patients undergoing pancreas transplantation (PT). This study evaluates PT patients to determine the pre transplant prevalence of CAD and assesses the post-transplant outcomes including complications and survival. Methods: This study is a retrospective review of PTs from 2003 to 2011. Diagnosis of CAD required cardiac catheterization. Outcomes included: myocardial infarction (MI), stroke, and survival. Results: There were 405 transplants in 389 patients with median follow-up of 56 months. Pre transplant prevalence of CAD was 19% (n = 74). There was no increased risk of perioperative, 90-d or one-yr mortality for patients with CAD. The CAD group did have increased risk of MI (11% vs. 1%, p < 0.001) and stroke (8% vs. 3%, p = 0.02). Controlling for patient and donor age, and history of CAD, the CAD group had decreased patient survival at five yr (82% vs. 90%, p = 0.09, HR 1.77) by Cox regression. Conclusions: Patients with type I diabetes and CAD have increased risk of MI and stroke post-pancreas transplant, with decreased five-yr survival. Patients without CAD and a negative pre transplant cardiac evaluation carry a low risk of post-transplant MI.

Original languageEnglish
JournalClinical Transplantation
Volume27
Issue number4
DOIs
StatePublished - Jul 2013

Fingerprint

Pancreas Transplantation
Coronary Artery Disease
Transplants
Myocardial Infarction
Survival
Stroke
Type 1 Diabetes Mellitus
Cardiac Catheterization
Pancreas
Tissue Donors

Keywords

  • Coronary artery disease
  • Myocardial infarction
  • Outcomes
  • Pancreas transplantation
  • Vascular disease

ASJC Scopus subject areas

  • Transplantation

Cite this

Pretransplant coronary artery disease associated with worse clinical outcomes in pancreas transplantation. / Mangus, Richard; Powelson, John; Kinsella, Sandra B.; Farar, Damond T.; Creal, Cristina A.; Fridell, Jonathan A.

In: Clinical Transplantation, Vol. 27, No. 4, 07.2013.

Research output: Contribution to journalArticle

Mangus, Richard ; Powelson, John ; Kinsella, Sandra B. ; Farar, Damond T. ; Creal, Cristina A. ; Fridell, Jonathan A. / Pretransplant coronary artery disease associated with worse clinical outcomes in pancreas transplantation. In: Clinical Transplantation. 2013 ; Vol. 27, No. 4.
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