Open AccessAn analysis of the survival outcomes of simultaneous pancreas and kidney transplantation compared to live donor kidney transplantation in patients with type 1 diabetes: a UK Transplant Registry study
Author(s) -
Barlow Adam D.,
SaebParsy Kourosh,
Watson Christopher J. E.
Publication year - 2017
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12957
Subject(s) - medicine , kidney transplantation , pancreas transplantation , transplantation , proportional hazards model , kidney , diabetes mellitus , type 1 diabetes , kidney disease , pancreas , surgery , univariate analysis , urology , multivariate analysis , endocrinology
Summary Transplant options for patients with type 1 diabetes and end‐stage renal disease ( ESRD ) include deceased donor kidney, live donor kidney ( LDK ) and simultaneous pancreas‐kidney ( SPK ) transplantation. The aim of this study was to compare outcomes between LDK and SPK for patients with type 1 diabetes and ESRD in the UK . Data on all SPK ( n = 1739) and LDK ( n = 385) transplants performed between January 2001 and December 2014 were obtained from the UK Transplant Registry. Unadjusted patient and kidney graft survival were calculated using the Kaplan–Meier method. Multivariate analysis of kidney graft and patient survival was performed using Cox proportional hazards regression. There was no significant difference in patient ( P = 0.435) or kidney graft survival ( P = 0.204) on univariate analysis. On multivariate analysis there was no association between LDK / SPK and patient survival [ HR 0.71 (0.47–1.06), P = 0.095]. However, LDK was associated with an overall lower risk for kidney graft failure [ HR 0.60 (0.38–0.94), P = 0.025]. SPK recipients with a functioning pancreas graft had significantly better kidney graft and patient survival than LDK recipients or those with a failed pancreas graft. SPK transplantation does not confer an overall survival advantage compared to LDK . However, those SPK recipients with a functioning pancreas have significantly better outcomes.