Improved patient survival with simultaneous pancreas and kidney transplantation in recipients with diabetic end-stage renal disease
Open accessAbstract
Aims/hypothesis We aimed to determine whether simultaneous pancreas and kidney (SPK) transplantation would improve patient and kidney graft survival in diabetic end-stage renal disease (ESRD) compared with kidney transplantation alone (KTA).Methods Follow-up data were retrieved for all 630 patients with diabetic ESRD who had received SPK or KTA at our centre from 1983 to the end of 2010. Recipients younger than 55 years of age received either an SPK (n = 222) or, if available, a single live donor kidney (LDK; n = 171). Older recipients and recipients with greater comorbidity received a single deceased donor kidney (DDK; n = 237). Survival was analysed by the Kaplan-Meier method and in multivariate Cox regression analysis adjusting for recipient and donor characteristics.Results Patient survival was superior in SPK compared with both LDK and DDK recipients in univariate analysis. Follow-up time (mean ± SD) after transplantation was 7.1 ± 5.7 years. Median actuarial patient survival was 14.0 years for SPK, 11.5 years for LDK and 6.7 years for DDK recipients. In multivariate analyses including recipient age, sex, treatment modality, time on dialysis and era, SPK transplantation was protective for all-cause mortality compared with both LDK (p = 0.02) and DDK (p = 0.029) transplantation. After the year 2000, overall patient survival improved compared with previous years (HR 0.40, 95% CI 0.30, 0.55; p < 0.001). Pancreas graft survival also improved after 2000, with a 5 year graft survival rate of 78% vs 61% in previous years (1988-1999).Conclusions/interpretation Recipients of SPK transplants have superior patient survival compared with both LDK and DDK recipients, with improved results seen over the last decade.
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Pancreas transplantation has been done for more than 50 years and is standard care for patients with end-stage renal failure who need a kidney transplant.
“Pancreas transplants have been performed for over 50 years and have become a standard-of-care treatment in individuals who have developed end-stage renal failure and require kidney transplantation.158”
From Type 1 diabetes (2018) · cites this paper as [158]
The Introduction dates the first pancreas transplant to 1966, consistent with a history of more than 50 years by the time of the citing statement. It calls transplantation an effective option especially for patients with diabetes and end-stage renal disease, but does not establish it as standard care for everyone with end-stage renal failure who needs a kidney transplant; it describes eligibility limits and kidney-only alternatives. (LLM, conf=0.87)
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Rocha‐Santos, V., & Pantanali, C. A. R. (2020) · Springer eBooks · doi:10.1007/978-3-030-53370-0_49 · Cited by 1 · see citing works
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Endothelial function after pancreas transplantation—A single‐center observational study
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- Authors
- Lindahl, J. P., Hartmann, A., Horneland, R., Holdaas, H., Reisæter, A. V., Midtvedt, K., Leivestad, T., Øyen, O., & Jenssen, T.
- Affiliations
- Oslo University Hospital (NO)
- Corresponding author
- Lindahl, J. P.
- ORCID
- Venue
- Diabetologia
- Published
- 2013-04-03
- Volume
- 56
- Issue
- 6
- Pages
- 1364-1371
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2067386593
- Cited by
- 61
- References
- 37
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 7 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 5 · 2014: 5 · 2013: 1
- FWCI
- 4.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Organ Donation and Transplantation
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Keywords
- simultaneous pancreas-kidney transplantation, diabetic end-stage renal disease, kidney transplantation, patient survival, renal allograft survival, living donor kidney, deceased donor kidney, all-cause mortality, diabetes mellitus
- MeSH terms
- Adult, Female, Graft Survival, Humans, Immunosuppressive Agents, Kidney Failure, Chronic, Male, Middle Aged, Regression Analysis, Retrospective Studies, Risk Factors, Time Factors, Multivariate Analysis, Proportional Hazards Models, Kidney Transplantation, Pancreas Transplantation, Treatment Outcome, Living Donors, Diabetes Complications
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