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Combined Kidney-Pancreas Transplant Improves Survival Chance in Diabetics
"Based on these results, we feel that all type 1 diabetics with kidney failure should be considered for simultaneous pancreas-kidney transplantation," comments Dr. Christian Morath of the University of Heidelberg, Germany.
Dr. Morath and colleagues analyzed the long-term outcomes of more than 11,000 patients with type 1 diabetes and ESRD who received a kidney transplant between 1984 and 2000. About 3,500 patients underwent simultaneous transplantation of the pancreas and kidney from a deceased donor. The remaining patients received a kidney only, from either a living or deceased donor.
Patient survival and survival of the transplanted kidney were evaluated after up to 18 years of follow-up. The goal was to see how adding pancreas transplantation to kidney transplantation affected the long-term outcomes.
Both patient and kidney survival were better for patients undergoing pancreas-kidney transplant or living-donor kidney transplant, compared to deceased-donor kidney transplant. At first, kidney survival rates were best for patients who received living-donor kidney transplants. However, by the end of the follow-up period, kidney survival rates were essentially the same for the pancreas-kidney and living-donor kidney groups.
When adjusted for other factors, patients receiving simultaneous pancreas-kidney transplants had better long-term survival. Beyond 10 years, the risk of death was 45 percent lower in the pancreas-kidney group than in the living-donor kidney group. The gain in survival with pancreas-kidney transplantation largely reflected a lower risk of death from cardiovascular disease: 37 percent, compared with 46 to 49 percent in patients receiving kidney transplants only.
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More News on: Diabetes - Self-Monitoring of Blood Glucose (SMBG), Diabetes and Exercise, Pregnancy and Complications, Glycemic Index
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