{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:24:32Z","timestamp":1787217872385,"version":"build-2736575974"},"reference-count":16,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020624","name":"NIHR Nottingham Biomedical Research Centre","doi-asserted-by":"publisher","award":["IS-BRC-1215-20003"],"award-info":[{"award-number":["IS-BRC-1215-20003"]}],"id":[{"id":"10.13039\/501100020624","id-type":"DOI","asserted-by":"publisher"}]},{"award":["IS-BRC-1215-20003"],"award-info":[{"award-number":["IS-BRC-1215-20003"]}],"id":[{"id":"https:\/\/ror.org\/046cr9566","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["MR\/Z505183\/1"],"award-info":[{"award-number":["MR\/Z505183\/1"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"award":["MR\/Z505183\/1"],"award-info":[{"award-number":["MR\/Z505183\/1"]}],"id":[{"id":"https:\/\/ror.org\/001aqnf71","id-type":"ROR","asserted-by":"publisher"}]},{"name":"NIHR Academic Clinical Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Alcohol use disorder (AUD) is generally regarded as a relative contraindication to pancreas transplantation. Yet the effect of documented AUD before transplantation on long-term results after pancreas transplantation is still poorly understood. Therefore, we used a large real-world electronic health records database to compare the three-year outcomes among pancreas transplant recipients who had and who had not had documented AUD before transplantation. Methods: We carried out a retrospective cohort study involving propensity score matching using the TriNetX US Collaborative Network. Each adult patient who had a documented case of alcohol use disorder (ICD-10-CM codes F10.1\/F10.2) before transplantation was paired one to one with a patient who did not have such a disorder, matching them on demographic characteristics, comorbidities, transplant-related factors, medications, body mass index, and glycated hemoglobin. The outcomes were evaluated from one day after transplantation up to three years later and comprised all-cause mortality, emergency visits, transplant complications, cachexia, severe protein\u2013calorie malnutrition, pain, vitamin deficiencies, iron deficiency anaemia, diarrhea, and adult failure to thrive. Results: Out of 14,367 eligible recipients, propensity score matching resulted in 439 patients in each group. Pretransplant AUD was linked to a significantly higher rate of all-cause mortality (15.1% compared with 8.5%; risk ratio [RR] 1.78, 95% CI 1.22\u20132.60; hazard ratio [HR] 1.86, 95% CI 1.25\u20132.78; p = 0.002). Cachexia affected 5.2% rather than 2.5% (RR 2.09, 95% CI 1.03\u20134.24; HR 2.16, 95% CI 1.06\u20134.44; p = 0.036), while diarrhea occurred in 39.6% compared with 28.2% (RR 1.40, 95% CI 1.16\u20131.69; HR 1.54, 95% CI 1.22\u20131.94; p &lt; 0.001). There were no significant differences in the case of emergency visits (49.0% versus 44.6%; p = 0.199), transplant complications (11.1% versus 14.4%; p = 0.163), severe protein\u2013calorie malnutrition (12.1% versus 8.9%; p = 0.123), pain (59.0% versus 54.7%; p = 0.195), vitamin deficiencies (31.4% versus 29.4%; p = 0.509), iron deficiency anemia (21.2% versus 21.9%; p = 0.805), or adult failure to thrive (7.3% versus 4.3%; p = 0.061). Conclusions: The presence of a history of alcohol use disorder (AUD) before transplantation was found to be independently linked to a higher three-year mortality rate, as well as the occurrence of cachexia and diarrhea after pancreas transplantation, but it was not associated with an increased number of coded transplant complications or most of the other adverse outcomes following the procedure. These results indicate that pancreas transplant recipients with a history of AUD should have enhanced monitoring in the areas of nutrition, the gastrointestinal system, and addiction.<\/jats:p>","DOI":"10.3390\/medsci14040497","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T16:12:58Z","timestamp":1787155978000},"page":"497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pancreas Transplant Recipients with and Without Pretransplant Alcohol Use Disorder: A Real-World Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1794-2569","authenticated-orcid":false,"given":"Arkadeep","family":"Dhali","sequence":"first","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"},{"name":"School of Medicine, Dentistry and Biomedical Sciences, Queen\u2019s University of Belfast, Belfast BT9 7BL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotirmoy","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Barasat Government Medical College and Hospital, Barasat 700124, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5315-9934","authenticated-orcid":false,"given":"Sajjad Ahmed","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Birat Medical College Teaching Hospital, Morang 56613, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2402-8890","authenticated-orcid":false,"given":"Fayaz","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1250-5295","authenticated-orcid":false,"given":"Saikat","family":"Mandal","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2698-0128","authenticated-orcid":false,"given":"Ashish","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Hospital Medicine, Yale New Haven Hospital, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8544-9039","authenticated-orcid":false,"given":"Dushyant Singh","family":"Dahiya","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, KS 66160, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2839-5158","authenticated-orcid":false,"given":"Manideepa","family":"Maji","sequence":"additional","affiliation":[{"name":"Hull York Medical School, University of Hull, Hull HU6 7RX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1016\/j.transproceed.2022.03.059","article-title":"The 2022 International Pancreas Transplant Registry Report\u2014A Review","volume":"54","author":"Gruessner","year":"2022","journal-title":"Transplant. 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Int."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/497\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:39:16Z","timestamp":1787215156000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":16,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["medsci14040497"],"URL":"https:\/\/doi.org\/10.3390\/medsci14040497","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]}}}