G E Gondolesi1, N F Aguirre2, D A Ramisch2, F A Mos2, N F Pedraza2, M R Fortunato3, L M Gutiérrez3, H Fraguas4, R Marrugat3, G E Rabin3, C Musso5, P A Farinelli4, P H L Barros Schelotto6, P M Raffaele3. 1. Unidad de Trasplante Reno-Pancreático, Hospital Universitario-Fundación Favaloro, Buenos Aires, Argentina. Electronic address: ggondolesi@ffavaloro.org. 2. Unidad de Trasplante Reno-Pancreático, Hospital Universitario-Fundación Favaloro, Buenos Aires, Argentina. 3. Unidad Renal, Hospital Universitario-Fundación Favaloro, Buenos Aires, Argentina. 4. Unidad de Cirugía Cardiovascular y Trasplante, Hospital Universitario-Fundación Favaloro, Buenos Aires, Argentina. 5. Unidad Metabólica, Hospital Universitario-Fundación Favaloro, Buenos Aires, Argentina. 6. Instituto de Trasplante Multiorgánico, Hospital Universitario-Fundación Favaloro, Buenos Aires, Argentina.
Abstract
BACKGROUND: Simultaneous pancreas-kidney transplantation (SPK) has become the treatment of choice for type 1 diabetes mellitus (T1DM) patients with chronic renal failure. Type 2 diabetes mellitus (T2DM), was once considered to be a contraindication for pancreas transplantation; however, it has been accepted as a new indication, under strict criteria. Although favorable results have increase the indication for T2DM in developed countries, there have been no reports of long-term results for this indication from Latin American centers. METHODS: From April 2008 to March 2016, patients receiving SPK or pancreas transplant alone (PTA) for T2DM were included and compared with T1DM recipients. Variables were compared between groups with the use of χ2 and t tests; Kaplan-Meier with log rank was used for patient and graft survivals; P < .05 was considered to be significant. RESULTS: A total of 45 SPK and 1 PTA were performed, 35 (76.1%) for T1DM and 11 (24.5%) for T2DM. Mean pre-transplantation C-peptide was significantly higher in the T2DM group (P = .01); HbA1c was higher in the T1DM group (P = .03). No differences were found in weight, body mass index, and pre-transplantation glycemia. Patient survivals for T1DM recipients were 88.2% and 84.8% at 1 and 5 years, respetively, versus 100% and 74.1% for T2DM recipients (P = .87). CONCLUSIONS: Our initial prospective experience in a single Latin American center showed that medium- and long-term outcomes for T1DM and T2DM individuals receiving pancreas transplants are similar, under strict selection criteria.
BACKGROUND: Simultaneous pancreas-kidney transplantation (SPK) has become the treatment of choice for type 1 diabetes mellitus (T1DM) patients with chronic renal failure. Type 2 diabetes mellitus (T2DM), was once considered to be a contraindication for pancreas transplantation; however, it has been accepted as a new indication, under strict criteria. Although favorable results have increase the indication for T2DM in developed countries, there have been no reports of long-term results for this indication from Latin American centers. METHODS: From April 2008 to March 2016, patients receiving SPK or pancreas transplant alone (PTA) for T2DM were included and compared with T1DM recipients. Variables were compared between groups with the use of χ2 and t tests; Kaplan-Meier with log rank was used for patient and graft survivals; P < .05 was considered to be significant. RESULTS: A total of 45 SPK and 1 PTA were performed, 35 (76.1%) for T1DM and 11 (24.5%) for T2DM. Mean pre-transplantation C-peptide was significantly higher in the T2DM group (P = .01); HbA1c was higher in the T1DM group (P = .03). No differences were found in weight, body mass index, and pre-transplantation glycemia. Patient survivals for T1DM recipients were 88.2% and 84.8% at 1 and 5 years, respetively, versus 100% and 74.1% for T2DM recipients (P = .87). CONCLUSIONS: Our initial prospective experience in a single Latin American center showed that medium- and long-term outcomes for T1DM and T2DM individuals receiving pancreas transplants are similar, under strict selection criteria.
Authors: Phuoc H Pham; Lily N Stalter; Eric J Martinez; Jesse F Wang; Bridget M Welch; Glen Leverson; Nicholas Marka; Talal Al-Qaoud; Didier Mandelbrot; Sandesh Parajuli; Hans W Sollinger; Dixon Kaufman; Robert R Redfield; Jon S Odorico Journal: Am J Transplant Date: 2021-01-15 Impact factor: 9.369