Is Age Just a Number? Outcomes of Simultaneous Pancreas‐Kidney Transplantation in Patients ≥60 Years—A Contemporary SRTR Analysis
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| Formato: | Artículo Open Access |
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Wiley
2026
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| author | Ruining Zhou Todd A. MacKenzie Matthew Wright Eman Shaban Michael Chobanian Michael F. Daily Abraham J. Matar |
| author_facet | Ruining Zhou Todd A. MacKenzie Matthew Wright Eman Shaban Michael Chobanian Michael F. Daily Abraham J. Matar Ruining Zhou Todd A. MacKenzie Matthew Wright Eman Shaban Michael Chobanian Michael F. Daily Abraham J. Matar |
| collection | Wiley Open Access |
| contents | Is Age Just a Number? Outcomes of Simultaneous Pancreas‐Kidney Transplantation in Patients ≥60 Years—A Contemporary SRTR Analysis Ruining Zhou Todd A. MacKenzie Matthew Wright Eman Shaban Michael Chobanian Michael F. Daily Abraham J. Matar Clinical Transplantation ABSTRACT Background Simultaneous pancreas–kidney (SPK) transplantation offers insulin independence and freedom from dialysis for appropriately selected candidates with diabetes and end‐stage renal disease. As SPK utilization increasingly extends to older recipients, including those aged ≥60 years, contemporary outcome data for these older recipients remains limited. This study evaluated age‐specific outcomes to inform the selection and counseling of older SPK candidates. Methods Adult SPK recipients in the United States from 2010 to 2025 were identified in the Scientific Registry of Transplant Recipients and categorized into three age groups: 18–39, 40–59, and ≥60 years. Primary endpoints were patient survival and death‐censored pancreas and kidney graft survival; secondary endpoints included 90‐day surgical and medical complications. Results Among 11 995 SPK recipients, 4938 (41%) were aged 18–39 years, 6718 (56%) were 40–59 years, and 339 (3%) were ≥60 years, with utilization in the ≥60 group increasing over time. Older recipients were more likely to have Type 2 diabetes, greater comorbidity burden, and to undergo preemptive transplantation. Death‐censored pancreas graft survival at 5 years improved across age strata (82.5% for 18–39, 87.5% for 40–59, and 92.2% for ≥60 years; p < 0.0001), as did death‐censored kidney graft survival (86.1%, 92.8%, and 94.2%, respectively; p < 0.0001). In contrast, 5‐year overall survival declined with age, from 92.4% (18–39) to 90.3% (40–59) and 82.6% (≥60; p < 0.0001), while 5‐year composite kidney graft survival or death was highest in the 40–59 group (81.4%, 85.0%, and 78.6% for 18–39, 40–59, and ≥60 years; p < 0.0001). Most perioperative complications were similar across age groups, although anastomotic leak was more frequent in recipients ≥60 years. Conclusions Carefully selected SPK recipients aged ≥60 years achieve excellent pancreas and kidney graft survival, often exceeding outcomes observed in younger adults, despite higher overall mortality. These findings support reconsideration of strict age‐based exclusion criteria and highlight the importance of nuanced risk–benefit discussions for older SPK candidates. 10.1111/ctr.70561 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.70561 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70561 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Is Age Just a Number? Outcomes of Simultaneous Pancreas‐Kidney Transplantation in Patients ≥60 Years—A Contemporary SRTR Analysis Ruining Zhou Todd A. MacKenzie Matthew Wright Eman Shaban Michael Chobanian Michael F. Daily Abraham J. Matar Clinical Transplantation Is Age Just a Number? Outcomes of Simultaneous Pancreas‐Kidney Transplantation in Patients ≥60 Years—A Contemporary SRTR Analysis Ruining Zhou Todd A. MacKenzie Matthew Wright Eman Shaban Michael Chobanian Michael F. Daily Abraham J. Matar Clinical Transplantation ABSTRACT Background Simultaneous pancreas–kidney (SPK) transplantation offers insulin independence and freedom from dialysis for appropriately selected candidates with diabetes and end‐stage renal disease. As SPK utilization increasingly extends to older recipients, including those aged ≥60 years, contemporary outcome data for these older recipients remains limited. This study evaluated age‐specific outcomes to inform the selection and counseling of older SPK candidates. Methods Adult SPK recipients in the United States from 2010 to 2025 were identified in the Scientific Registry of Transplant Recipients and categorized into three age groups: 18–39, 40–59, and ≥60 years. Primary endpoints were patient survival and death‐censored pancreas and kidney graft survival; secondary endpoints included 90‐day surgical and medical complications. Results Among 11 995 SPK recipients, 4938 (41%) were aged 18–39 years, 6718 (56%) were 40–59 years, and 339 (3%) were ≥60 years, with utilization in the ≥60 group increasing over time. Older recipients were more likely to have Type 2 diabetes, greater comorbidity burden, and to undergo preemptive transplantation. Death‐censored pancreas graft survival at 5 years improved across age strata (82.5% for 18–39, 87.5% for 40–59, and 92.2% for ≥60 years; p < 0.0001), as did death‐censored kidney graft survival (86.1%, 92.8%, and 94.2%, respectively; p < 0.0001). In contrast, 5‐year overall survival declined with age, from 92.4% (18–39) to 90.3% (40–59) and 82.6% (≥60; p < 0.0001), while 5‐year composite kidney graft survival or death was highest in the 40–59 group (81.4%, 85.0%, and 78.6% for 18–39, 40–59, and ≥60 years; p < 0.0001). Most perioperative complications were similar across age groups, although anastomotic leak was more frequent in recipients ≥60 years. Conclusions Carefully selected SPK recipients aged ≥60 years achieve excellent pancreas and kidney graft survival, often exceeding outcomes observed in younger adults, despite higher overall mortality. These findings support reconsideration of strict age‐based exclusion criteria and highlight the importance of nuanced risk–benefit discussions for older SPK candidates. 10.1111/ctr.70561 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Is Age Just a Number? Outcomes of Simultaneous Pancreas‐Kidney Transplantation in Patients ≥60 Years—A Contemporary SRTR Analysis |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70561 |