Glycemic Control in Simultaneous Islet-Kidney Versus Pancreas-Kidney Transplantation in Type 1 Diabetes: A Prospective 13-Year Follow-up
Abstract
Objective In patients with type 1 diabetes and end-stage renal disease, combined transplantation of a kidney together with a pancreas or isolated pancreatic islets are options to improve glycemic control. The aim of this study was to compare their long-term outcome with regard to metabolic control and surgical complication rate, as well as function of the transplanted kidney. Research design and methods We conducted a prospective cohort study in consecutive patients receiving either a pancreas or islet transplant simultaneously with or after kidney transplantation (simultaneous pancreas-kidney [SPK]/pancreas-after-kidney [PAK] or simultaneous islet-kidney [SIK]/islet-after-kidney [IAK] transplantation). Results Ninety-four patients who had undergone SPK/PAK transplantation were compared with 38 patients who had undergone SIK/IAK transplantation over a period of up to 13 years. HbA1c levels declined from 7.8 ± 1.3% (62 ± 14 mmol/mol) to 5.9 ± 1.1% (41 ± 12 mmol/mol), and from 8.0 ± 1.3% (64 ± 14 mmol/mol) to 6.5 ± 1.1% (48 ± 12 mmol/mol), respectively, in the SPK/PAK and SIK/IAK groups (P 90%. The 5-year insulin independence rate was higher in the SPK/PAK group (73.6 vs. 9.3% in the SIK/IAK group), as was the rate of relaparotomy after transplantation (41.5 vs. 10.5% in the SIK/IAK group). There was no difference in the rate of kidney function decline. Conclusions During a long-term follow-up, SPK/PAK transplantation as well as SIK/IAK transplantation resulted in a sustained i…
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With an SPK transplant, most recipients can expect amelioration of problematic hypoglycemia for more than a decade.
“With an SPK transplant, most recipients can expect amelioration of problematic hypoglycemia for more than a decade (229-231).”
Cites
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Holt, R. I. G., DeVries, J. H., Hess-Fischl, A., Hirsch, I. B., Kirkman, M. S., Klupa, T., Ludwig, B., Nørgaard, K., Pettus, J., Renard, E., et al. (2021) · Diabetes Care · doi:10.2337/dci21-0043 · Cited by 699 · see citing works
The Role of Oxidative Stress and Hypoxia in Pancreatic Beta-Cell Dysfunction in Diabetes Mellitus
Gerber, P. A., & Rutter, G. A. (2017) · Antioxidants & Redox Signaling · doi:10.1089/ars.2016.6755 · Cited by 654 · see citing works
Self-citationMarfil-Garza, B. A., Imes, S., Verhoeff, K., Hefler, J., Lam, A., Dajani, K., Anderson, B., O'Gorman, D., Kin, T., Bigam, D., et al. (2022) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00114-0 · Cited by 205 · see citing works
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Chetboun, M., Drumez, E., Ballou, C., Maanaoui, M., Payne, E., Barton, F., Kerr-Conte, J., Vantyghem, M.-C., Piemonti, L., Rickels, M. R., et al. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(23)00082-7 · Cited by 64 · see citing works
- Authors
- Lehmann, R., Graziano, J., Brockmann, J., Pfammatter, T., Kron, P., de Rougemont, O., Mueller, T., Zuellig, R. A., Spinas, G. A., & Gerber, P. A.
- Affiliations
- University Hospital Zurich (CH)
- Division of Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2015-02-09
- Volume
- 38
- Issue
- 5
- Pages
- 752-759
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2143355825
- Cited by
- 94
- References
- 1
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 7 · 2023: 10 · 2022: 11 · 2021: 9 · 2020: 6 · 2019: 9 · 2018: 7 · 2017: 7 · 2016: 9 · 2015: 9
- FWCI
- 10.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Funders
- University of Zurich
- Promedica foundation
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 1 diabetes, simultaneous pancreas-kidney transplantation, pancreas after kidney transplantation, glycemic control, HbA1c, insulin independence, hypoglycemia, relaparotomy, renal function decline, end-stage renal disease, long-term outcomes, surgical complications, islet transplantation
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Humans, Kidney Failure, Chronic, Male, Middle Aged, Postoperative Complications, Prospective Studies, Cohort Studies, Kidney Transplantation, Pancreas Transplantation, Islets of Langerhans Transplantation, Treatment Outcome
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