Open AccessImproved patient survival in recipients of simultaneous pancreas–kidney transplant compared with kidney transplant alone in patients with type 1 diabetes mellitus and end‐stage renal disease
Author(s) -
Mohan P.,
Safi K.,
Little D. M.,
Donohoe J.,
Conlon P.,
Walshe J. J.,
O'Kelly P.,
Thompson C. J.,
Hickey D. P.
Publication year - 2003
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.4208
Subject(s) - medicine , azathioprine , calcineurin , diabetes mellitus , tacrolimus , urology , transplantation , surgery , kidney disease , kidney transplantation , kidney , end stage renal disease , gastroenterology , disease , hemodialysis , endocrinology
Background: There are emerging data that simultaneous pancreas–kidney transplant (SPK) prolongs life compared with kidney transplant alone (KTA) in type 1 diabetics with end‐stage renal disease. This study was a retrospective comparison of SPK with KTA in patients with type 1 diabetes. Methods: Between 1 January 1992 and 30 April 2002, 101 patients with type 1 diabetes were transplanted. Fifty‐one of these patients received a KTA and 50 had a SPK. All patients underwent coronary angiography with surgical correction of any coronary artery disease before being listed. All patients who underwent SPK received quadruple immunosuppressive therapy consisting of antilymphocyte globulin, calcineurin inhibitor (tacrolimus or cyclosporin), azathioprine and steroids. Those who underwent KTA received calcineurin inhibitor (tacrolimus or cyclosporin), azathioprine and steroids. Results: Patient survival at 1, 3, 5 and 8 years was 96, 93, 89 and 77 per cent respectively after SPK, and 93, 75, 57 and 47 per cent respectively after KTA ( P = 0·018 at 8 years). Conclusion: The addition of pancreatic transplantation prolongs life in type 1 diabetic patients with renal failure compared with renal transplantation alone. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.