» Articles » PMID: 35781938

Pancreas Transplantation in Black, Asian and Minority Ethnic Patients-Single Centre Experience in the UK

Overview
Journal Transpl Int
Specialty General Surgery
Date 2022 Jul 5
PMID 35781938
Authors
Affiliations
Soon will be listed here.
Abstract

Ethnic disparities in the outcomes after simultaneous pancreas kidney (SPK) transplantation still exist. The influence of ethnicity on the outcomes of pancreas transplantation in the UK has not been reported and hence we aimed to investigate our cohort. A retrospective analysis of all pancreas transplant recipients ( = 171; Caucasians = 118/Black Asian Ethnic Minorities, BAME = 53) from 2006 to 2020 was done. The median follow-up was 80 months. Patient & pancreas graft survival, rejection rate, steroid free maintenance rate, HbA1c, weight gain, and the incidence of secondary diabetic complications post-transplant were compared between the groups. < 0.003 was considered significant (corrected for multiple hypothesis testing). Immunosuppression consisted of alemtuzumab induction and steroid free maintenance with tacrolimus and mycophenolate mofetil. Pancreas graft & patient survival were equivalent in both the groups. BAME recipients had a higher prevalence of type-2 diabetes mellitus pre-transplant (BAME = 30.19% vs. Caucasians = 0.85%, < 0.0001), and waited for a similar time to transplantation once waitlisted, although pre-emptive SPK transplantation rate was higher for Caucasian recipients (Caucasians = 78.5% vs. BAME = 0.85%, < 0.0001). Despite equivalent rejections & steroid usage, BAME recipients gained more weight (BAME = 7.7% vs. Caucasians = 1.8%, = 0.001), but had similar HbA1c (functioning grafts) at 3-,12-, 36-, and 60-months post-transplant.

Citing Articles

Taking a "Care Pathway/Whole Systems" Approach to Equality Diversity Inclusion (EDI) in Organ Donation and Transplantation in Relation to the Needs of "Ethnic/Racial/Migrant" Minority Communities: A Statement and a Call for Action.

Grossi A, Randhawa G, Jansen N, Paredes-Zapata D Transpl Int. 2023; 36:11310.

PMID: 37600748 PMC: 10437067. DOI: 10.3389/ti.2023.11310.

References
1.
Morath C, Zeier M, Dohler B, Schmidt J, Nawroth P, Opelz G . Metabolic control improves long-term renal allograft and patient survival in type 1 diabetes. J Am Soc Nephrol. 2008; 19(8):1557-63. PMC: 2488262. DOI: 10.1681/ASN.2007070804. View

2.
ISAACS R, Lobo P, Nock S, Hanson J, Ojo A, Pruett T . Racial disparities in access to simultaneous pancreas-kidney transplantation in the United States. Am J Kidney Dis. 2000; 36(3):526-33. DOI: 10.1053/ajkd.2000.9793. View

3.
Knight R, Islam A, Pham C, Graviss E, Nguyen D, Moore L . Weight Gain After Simultaneous Kidney and Pancreas Transplantation. Transplantation. 2019; 104(3):632-639. DOI: 10.1097/TP.0000000000002862. View

4.
Riffaut N, Lobbedez T, Hazzan M, Bertrand D, Westeel P, Launoy G . Access to preemptive registration on the waiting list for renal transplantation: a hierarchical modeling approach. Transpl Int. 2015; 28(9):1066-73. DOI: 10.1111/tri.12592. View

5.
Brooks J, Liu R, Oliver M, DeLeonibus A, Mei J, White D . Simultaneous Pancreas and Kidney Transplantation is Associated With Inferior Long-Term Outcomes in African Americans. Pancreas. 2017; 47(1):116-121. DOI: 10.1097/MPA.0000000000000958. View