The impact of race on metabolic, graft, and patient outcomes after pancreas transplantation

Am J Surg. 2022 Apr;223(4):812-816. doi: 10.1016/j.amjsurg.2021.06.005. Epub 2021 Jun 17.

Abstract

Background: Racial disparities following pancreas transplantation (PTX) are poorly defined.

Methods: This was a large-scale, single-center, longitudinal cohort study including adult PTX recipients. Patients were grouped by race to allow for comparisons.

Results: 287 PTX recipients were included; 125 (43.5%) were African American (AA). At baseline, AAs had a significantly higher proportion of T2DM (19.4% vs. 5.7%, p = 0.001), were younger, and more likely to be female. AAs experienced significantly higher rates of pancreatic leaks and post-operative bleeding. PTX rejection was comparable, however, kidney rejection tended to be higher among AA SPKs. Long-term mean HgbA1C levels were significantly higher among AAs (6.9% vs. 6.3%, p = 0.039). Patient and graft survival was comparable between groups, but early patient survival tended to be lower in AAs.

Conclusions: This study demonstrated significant perioperative health disparities among AA PTX recipients, including poorer glycemic control and more early deaths, despite similar long-term patient and graft survival.

Keywords: African americans; Diabetes mellitus; Graft survival; Healthcare disparities; Pancreas transplantation.

MeSH terms

  • Adult
  • Female
  • Graft Rejection / epidemiology
  • Graft Survival
  • Humans
  • Kidney Transplantation*
  • Longitudinal Studies
  • Male
  • Pancreas Transplantation*
  • Retrospective Studies