Combined Pancreas-Kidney Transplantation for Patients With End-Stage Nephropathy Caused by Type-2 Diabetes Mellitus

• DOI: 10.1097/tp.0b013e3182861945
• Publication Date: 2013-05-23T19:44:03Z
• Authors: Christian Margreiter; Thomas Resch; Rupert Oberhuber; Felix Aigner; Herbert Maier; Robert Sucher; Stefan Schneeberger; Hanno Ulmer; Claudia Bösmüller; Raimund Margreiter; Johann Pratschke; Robert Öllinger
• Keywords: Pancreas transplantation

Background Simultaneous pancreas-kidney (SPK) transplantation is widely accepted as an optimal therapeutic option for patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease, but the indication 2 (T2DM) still controversially discussed. Methods Twenty-one T2DM recipients of a first combined graft performed at our center during 9-year period were retrospectively analyzed regard to demographic characteristics; cardiovascular risk factors; surgical, immunological, infectious complications; patient survivals compared T1DM (n=195) 32 who received kidney transplant alone (KTA) same period. Results Patient survival 5 years was 96.9% 91.6% group, 90.5% 80.1% 87.1% 54.2% KTA respectively (P<0.001). Actuarial pancreas SPK calculated be 92.6% 80.7% group 81.0% 75.9% (P=0.19). Kidney allograft 83.6% T1DM, 80.4% T2DM, 52.7% (P<0.0001). Multivariate analysis adjusting donor recipient age, secondary complications diabetes, body mass index, waiting time, cold ischemic delayed function, coronary factors showed that differences did not remain statistically significant. Conclusion Favorable results can achieved in diabetics low profile. A high cardiac death rate impacts calls stringent selection.