{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T23:48:06Z","timestamp":1781740086084,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,11]],"date-time":"2021-01-11T00:00:00Z","timestamp":1610323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32AI125222"],"award-info":[{"award-number":["T32AI125222"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Lower extremity (LE) vascular disease and adverse cardiovascular events (ACEs) cause significant long\u2010term morbidity after simultaneous pancreas\u2010kidney (SPK) transplantation. This study's purpose was to describe the incidence of, and risk factors associated with, LE vascular complications and related ACEs following SPK. All SPKs performed at the authors\u2019 institution from 2000 to 2019 were retrospectively analyzed. The primary outcome was any LE vascular event, defined as LE endovascular intervention, open surgery, amputation, or invasive podiatry intervention. Secondary outcomes included post\u2010SPK ACE. A total of 363 patients were included, of whom 54 (14.9%) required at least one LE vascular intervention following SPK. Only 3 patients received pre\u2010SPK ankle brachial indices (ABIs). A history of peripheral artery disease (PAD) (HR 2.95, CI 1.4\u20106.2) was a risk factor for post\u2010SPK LE vascular intervention even after adjustment for other factors. Fifty\u2010nine (16.3%) patients experienced an ACE in follow\u2010up. Requiring a LE intervention post\u2010SPK was associated with a subsequent ACE (HR 2.3, CI 1.2\u20104.5). LE vascular and cardiovascular complications continue to be significant sources of morbidity for SPK patients, especially for patients with preexisting PAD. The highest risk patients may benefit from more intensive pre\u2010 and post\u2010SPK workup with ABIs and follow\u2010up with a vascular surgeon.<\/jats:p>","DOI":"10.1111\/ctr.14195","type":"journal-article","created":{"date-parts":[[2020,12,19]],"date-time":"2020-12-19T12:23:12Z","timestamp":1608380592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Long\u2010term Lower Extremity and Cardiovascular Complications after Simultaneous Pancreas\u2010Kidney Transplant"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5288-2090","authenticated-orcid":false,"given":"Dominic","family":"Amara","sequence":"first","affiliation":[{"name":"School of Medicine University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3789-1751","authenticated-orcid":false,"given":"Hillary 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