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.
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.
Authors: Christian Morath; Martin Zeier; Bernd Döhler; Jan Schmidt; Peter P Nawroth; Vedat Schwenger; Gerhard Opelz Journal: Clin J Am Soc Nephrol Date: 2010-01-21 Impact factor: 8.237
Authors: H U Meier-Kriesche; F K Port; A O Ojo; S M Rudich; J A Hanson; D M Cibrik; A B Leichtman; B Kaplan Journal: Kidney Int Date: 2000-09 Impact factor: 10.612
Authors: A O Ojo; H U Meier-Kriesche; J A Hanson; A Leichtman; J C Magee; D Cibrik; R A Wolfe; F K Port; L Agodoa; D B Kaufman; B Kaplan Journal: Transplantation Date: 2001-01-15 Impact factor: 4.939
Authors: Y F Smets; R G Westendorp; J W van der Pijl; F T de Charro; J Ringers; J W de Fijter; H H Lemkes Journal: Lancet Date: 1999-06-05 Impact factor: 79.321
Authors: Brian Y Young; Jagbir Gill; Edmund Huang; Steven K Takemoto; Bishoy Anastasi; Tariq Shah; Suphamai Bunnapradist Journal: Clin J Am Soc Nephrol Date: 2009-02-06 Impact factor: 8.237
Authors: Hans W Sollinger; Jon S Odorico; Yolanda T Becker; Anthony M D'Alessandro; John D Pirsch Journal: Ann Surg Date: 2009-10 Impact factor: 12.969
Authors: Jørn P Lindahl; Finn P Reinholt; Ivar A Eide; Anders Hartmann; Karsten Midtvedt; Hallvard Holdaas; Linda T Dorg; Trine M Reine; Svein O Kolset; Rune Horneland; Ole Øyen; Knut Brabrand; Trond Jenssen Journal: Diabetologia Date: 2014-08-22 Impact factor: 10.122
Authors: Trine Marita Reine; Ingrid Benedicte Moss Kolseth; Astri Jeanette Meen; Jørn Petter Lindahl; Trond Geir Jenssen; Finn Per Reinholt; Joseph Zaia; Chun Shao; Anders Hartmann; Svein Olav Kolset Journal: Diabetes Res Clin Pract Date: 2014-10-28 Impact factor: 5.602