{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T14:29:35Z","timestamp":1743344975527,"version":"3.37.3"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["V110B-023","V110C-010","V110C-011"],"award-info":[{"award-number":["V110B-023","V110C-010","V110C-011"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Science and Technology","award":["MOST 108-2314-B-075 -051 -MY3"],"award-info":[{"award-number":["MOST 108-2314-B-075 -051 -MY3"]}]},{"name":"Ministry of Health and Welfare","award":["MOHW107-TDU-B-212-114026A","MOHW107-TDU-B-212-114026A"],"award-info":[{"award-number":["MOHW107-TDU-B-212-114026A","MOHW107-TDU-B-212-114026A"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Theoretically, pancreas transplant alone in uremic (PTAU) patients could also be one of the options for those waiting for both pancreas and kidney grafts, but it has never been reported. There were 160 cases of pancreas transplant in this study, including 16% PTAU. The 5-year patient survival was 66.2% after PTAU, 94.5% after SPK, 95.8% after PAK, and 95.4% after PTA. Rejection of pancreas graft was significantly lower in PTAU group (3.8%), followed by 16.7% in pancreas after kidney transplant (PAK), 29.8% in simultaneous pancreas and kidney transplant (SPK) and 37.0% in pancreas transplant alone (PTA). Fasting blood sugar and serum HbA1c levels after PTAU were not significantly different from those by other subgroups. The 5-year death-censored pancreas graft survival was 100% after PTAU and PAK, and 97.0% after SPK and 77.9% after PTA. However, the 5-year death-uncensored pancreas graft survival was 67.0% after PTAU, 100% after PAK, 91.3% after SPK, and 74.0% after PTA. The superior graft survival in the PTAU group was achieved only if deaths with a functioning graft were censored. In conclusion, given the inferior patient survival outcome, PTAU is still not recommended unless SPK and PAK is not available. Although PTAU could be a treatment option for patients with diabetes complicated by end-stage renal disease (ESRD) in terms of surgical risks, endocrine function, and immunological and graft survival outcomes, modification of the organ allocation policies to prioritize SPK transplant in eligible patients should be the prime goal.<\/jats:p>","DOI":"10.1038\/s41598-021-00621-y","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T10:02:49Z","timestamp":1635242569000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Inferior survival outcomes of pancreas transplant alone in uremic patients"],"prefix":"10.1038","volume":"11","author":[{"given":"Bor-Uei","family":"Shyr","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bor-Shiuan","family":"Shyr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Chin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Ming","family":"Shyr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin-E.","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"key":"621_CR1","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1111\/ajt.15673","volume":"20","author":"R Kandaswamy","year":"2020","unstructured":"Kandaswamy, R. et al. OPTN\/SRTR 2018 annual data report: Pancreas. Am. J. Transplant 20, 131\u2013192. https:\/\/doi.org\/10.1111\/ajt.15673 (2020).","journal-title":"Am. J. Transplant"},{"issue":"Suppl 2","key":"621_CR2","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1111\/ajt.15275","volume":"19","author":"R Kandaswamy","year":"2019","unstructured":"Kandaswamy, R. et al. OPTN\/SRTR 2017 annual data report: Pancreas. Am. J. Transplant 19(Suppl 2), 124\u2013183. https:\/\/doi.org\/10.1111\/ajt.15275 (2019).","journal-title":"Am. J. Transplant"},{"issue":"Suppl 1","key":"621_CR3","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1111\/ajt.14558","volume":"18","author":"R Kandaswamy","year":"2018","unstructured":"Kandaswamy, R. et al. OPTN\/SRTR 2016 annual data report: Pancreas. Am. J. Transplant 18(Suppl 1), 114\u2013171. https:\/\/doi.org\/10.1111\/ajt.14558 (2018).","journal-title":"Am. J. Transplant"},{"key":"621_CR4","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1111\/tri.13562","volume":"33","author":"KR Posegger","year":"2020","unstructured":"Posegger, K. R. et al. The quality of life in type I diabetic patients with end-stage kidney disease before and after simultaneous pancreas-kidney transplantation: A single-center prospective study. Transpl. Int. 33, 330\u2013339. https:\/\/doi.org\/10.1111\/tri.13562 (2020).","journal-title":"Transpl. Int."},{"key":"621_CR5","doi-asserted-by":"publisher","first-page":"957","DOI":"10.2215\/cjn.03180411","volume":"6","author":"DB Kaufman","year":"2011","unstructured":"Kaufman, D. B. & Sutherland, D. E. Simultaneous pancreas-kidney transplants are appropriate in insulin-treated candidates with uremia regardless of diabetes type. Clin. J. Am. Soc. Nephrol. 6, 957\u2013959. https:\/\/doi.org\/10.2215\/cjn.03180411 (2011).","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"621_CR6","doi-asserted-by":"publisher","first-page":"E256","DOI":"10.1111\/ctr.12100","volume":"27","author":"J Light","year":"2013","unstructured":"Light, J. & Tucker, M. Simultaneous pancreas kidney transplants in diabetic patients with end-stage renal disease: The 20-yr experience. Clin. Transplant 27, E256-263. https:\/\/doi.org\/10.1111\/ctr.12100 (2013).","journal-title":"Clin. Transplant"},{"key":"621_CR7","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000002960","author":"S Parajuli","year":"2019","unstructured":"Parajuli, S. et al. More than 25 years of pancreas graft survival after simultaneous pancreas and kidney transplantation: Experience from the world\u2019s largest series of long-term survivors. Transplantation https:\/\/doi.org\/10.1097\/tp.0000000000002960 (2019).","journal-title":"Transplantation"},{"key":"621_CR8","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.2215\/CJN.06860810","volume":"6","author":"MS Sampaio","year":"2011","unstructured":"Sampaio, M. S., Kuo, H. T. & Bunnapradist, S. Outcomes of simultaneous pancreas-kidney transplantation in type 2 diabetic recipients. Clin. J. Am. Soc. Nephrol. 6, 1198\u20131206. https:\/\/doi.org\/10.2215\/CJN.06860810 (2011).","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"621_CR9","doi-asserted-by":"publisher","first-page":"2650","DOI":"10.1016\/j.transproceed.2010.04.065","volume":"42","author":"HA Chakkera","year":"2010","unstructured":"Chakkera, H. A. et al. Outcomes after simultaneous pancreas and kidney transplantation and the discriminative ability of the C-peptide measurement pretransplant among type 1 and type 2 diabetes mellitus. Transplant Proc. 42, 2650\u20132652. https:\/\/doi.org\/10.1016\/j.transproceed.2010.04.065 (2010).","journal-title":"Transplant Proc."},{"key":"621_CR10","doi-asserted-by":"publisher","first-page":"81","DOI":"10.5500\/wjt.v9.i4.81","volume":"9","author":"A Aref","year":"2019","unstructured":"Aref, A., Zayan, T., Pararajasingam, R., Sharma, A. & Halawa, A. Pancreatic transplantation: Brief review of the current evidence. World J. Transplant 9, 81\u201393. https:\/\/doi.org\/10.5500\/wjt.v9.i4.81 (2019).","journal-title":"World J. Transplant"},{"key":"621_CR11","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1097\/TP.0b013e3182861945","volume":"95","author":"C Margreiter","year":"2013","unstructured":"Margreiter, C. et al. Combined pancreas-kidney transplantation for patients with end-stage nephropathy caused by type-2 diabetes mellitus. Transplantation 95, 1030\u20131036. https:\/\/doi.org\/10.1097\/TP.0b013e3182861945 (2013).","journal-title":"Transplantation"},{"key":"621_CR12","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13732","volume":"33","author":"S Parajuli","year":"2019","unstructured":"Parajuli, S. et al. Outcomes after simultaneous kidney-pancreas versus pancreas after kidney transplantation in the current era. Clin. Transplant 33, e13732. https:\/\/doi.org\/10.1111\/ctr.13732 (2019).","journal-title":"Clin. Transplant"},{"key":"621_CR13","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1900\/RDS.2016.13.e2016002","volume":"13","author":"AC Gruessner","year":"2016","unstructured":"Gruessner, A. C. & Gruessner, R. W. Pancreas Transplantation of US and Non-US Cases from 2005 to 2014 as Reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR). Rev. Diabet. Stud. 13, 35\u201358. https:\/\/doi.org\/10.1900\/RDS.2016.13.e2016002 (2016).","journal-title":"Rev. Diabet. Stud."},{"key":"621_CR14","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1093\/bmb\/ldx039","volume":"124","author":"S Dholakia","year":"2017","unstructured":"Dholakia, S. et al. The rise and potential fall of pancreas transplantation. Br. Med. Bull. 124, 171\u2013179. https:\/\/doi.org\/10.1093\/bmb\/ldx039 (2017).","journal-title":"Br. Med. Bull."},{"issue":"Suppl 2","key":"621_CR15","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/ajt.13667","volume":"16","author":"R Kandaswamy","year":"2016","unstructured":"Kandaswamy, R. et al. Pancreas. Am. J. Transplant 16(Suppl 2), 47\u201368. https:\/\/doi.org\/10.1111\/ajt.13667 (2016).","journal-title":"Am. J. Transplant"},{"key":"621_CR16","doi-asserted-by":"publisher","DOI":"10.3390\/toxins12040224","author":"MG Betjes","year":"2020","unstructured":"Betjes, M. G. Uremia-associated ageing of the thymus and adaptive immune responses. Toxins (Basel) https:\/\/doi.org\/10.3390\/toxins12040224 (2020).","journal-title":"Toxins (Basel)"},{"key":"621_CR17","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1159\/000356084","volume":"36","author":"MG Betjes","year":"2013","unstructured":"Betjes, M. G., Meijers, R. W. & Litjens, N. H. Loss of renal function causes premature aging of the immune system. Blood Purif. 36, 173\u2013178. https:\/\/doi.org\/10.1159\/000356084 (2013).","journal-title":"Blood Purif."},{"key":"621_CR18","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1093\/ndt\/gfy276","volume":"35","author":"T Crepin","year":"2020","unstructured":"Crepin, T. et al. Uraemia-induced immune senescence and clinical outcomes in chronic kidney disease patients. Nephrol. Dial. Transplant 35, 624\u2013632. https:\/\/doi.org\/10.1093\/ndt\/gfy276 (2020).","journal-title":"Nephrol. Dial. Transplant"},{"key":"621_CR19","doi-asserted-by":"publisher","first-page":"e0227719","DOI":"10.1371\/journal.pone.0227719","volume":"15","author":"A Nongnuch","year":"2020","unstructured":"Nongnuch, A. et al. Immune response to influenza vaccination in ESRD patients undergoing hemodialysis vs hemodiafiltration. PLoS ONE 15, e0227719. https:\/\/doi.org\/10.1371\/journal.pone.0227719 (2020).","journal-title":"PLoS ONE"},{"key":"621_CR20","first-page":"84","volume":"9","author":"MR Sharif","year":"2015","unstructured":"Sharif, M. R. et al. Immune disorders in hemodialysis patients. Iran J. Kidney Dis. 9, 84\u201396 (2015).","journal-title":"Iran J. Kidney Dis."},{"key":"621_CR21","doi-asserted-by":"publisher","first-page":"921","DOI":"10.2174\/187152711799219271","volume":"10","author":"S Banu","year":"2011","unstructured":"Banu, S., Jabir, N. R., Manjunath, C. N., Shakil, S. & Kamal, M. A. C-peptide and its correlation to parameters of insulin resistance in the metabolic syndrome. CNS Neurol. Disord. Drug Targets 10, 921\u2013927. https:\/\/doi.org\/10.2174\/187152711799219271 (2011).","journal-title":"CNS Neurol. Disord. Drug Targets"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-00621-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-00621-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-00621-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T16:52:33Z","timestamp":1670086353000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-00621-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,26]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["621"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-00621-y","relation":{},"ISSN":["2045-2322"],"issn-type":[{"type":"electronic","value":"2045-2322"}],"subject":[],"published":{"date-parts":[[2021,10,26]]},"assertion":[{"value":"1 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"21073"}}