Perioperative Severe Complications Can Cause Pancreatic Graft Failure and Mortality in Pancreas Transplantation

Abstract

Background: Pancreas transplantation (PTx) is a radical treatment for type 1 diabetes, frequently associated with complications. Herein, we examined the impact of severe perioperative complications on pancreatic graft and recipient survival.

Methods: Between January 2010 and December 2024, 40 patients with type 1 diabetes underwent PTx: 35 underwent simultaneous PTx and kidney transplantation, and 5 underwent PTx after kidney transplantation. Pancreatic graft and recipient survival rates were compared between recipients with and without severe perioperative complications defined by grades more severe than grade Ⅱ in the Clavien-Dindo classification, using the Kaplan-Meier survival curve and log-rank tests.

Results: Although severe perioperative complications were identified in 12 recipients (30.0%), no perioperative mortality was observed. Pancreatic graft failure and mortality occurred in 4 (33.3%) and 3 (25.0%) recipients, respectively, along with severe perioperative complications. In contrast, in recipients without severe perioperative complications, pancreatic graft failure and mortality occurred in 3 (10.7%) and 1 (3.6%) recipients, respectively. Pancreatic graft failure and recipient mortality were significantly higher in recipients with severe perioperative complications than in those without severe perioperative complications (P = .024 and P = .017, respectively).

Conclusion: Severe perioperative complications can result in pancreatic graft failure and mortality. Appropriate surgical interventions are required to prevent severe perioperative complications.