Single center results of simultaneous pancreas-kidney transplantation in patients with type 2 diabetes.
Eric J. Martinez M.D.
Pham, P. H., L. N. Stalter, E. J. Martinez, J. F. Wang, B. M. Welch, G. Leverson, N. Marka, T. Al-Qaoud, D. Mandelbrot, S. Parajuli, H. W. Sollinger, D. Kaufman, R. R. Redfield and J. S. Odorico (2021). “Single center results of simultaneous pancreas-kidney transplantation in patients with type 2 diabetes.” Am J Transplant 21(8): 2810-2823.
Studies have found similar outcomes of Simultaneous Pancreas-Kidney transplantation (SPKT) in patients with Type 2 (T2D) and Type 1 diabetes (T1D). However, there are scarce data evaluating the association of recipient factors such as age, BMI, or pretransplant insulin requirements with outcomes, thus the criteria for the optimal recipient selection remains unclear. In this study, 284 T1D and 39 T2D patients, who underwent SPKT between 2006 and 2017 with 1 year of follow-up at minimum, were assessed for potential relationship of pretransplant BMI and insulin requirements with posttransplant diabetes and pancreatic graft failure. Kaplan-Meier analysis showed similar rates of freedom from posttransplant diabetes (94.7% T2D vs. 92.3% T1D at 1 yr, and 88.1% T2D vs. 81.1% T1D at 5 yrs) and graft survival (89.7% T2D vs. 90.4% T1D at 1 yr, and 89.7% T2D vs. 81.2% T1D at 5 yrs). There was no significant association between BMI or pretransplant insulin requirements with posttransplant diabetes occurrence in either T1D (p = .10, .43, respectively) or T2D (p = .12, .63) patients in the cohort; or with graft failure (T1D: p = .40, .09; T2D: p = .71, .28). These observations suggest a less restricted approach to selective use of SPKT in patients with T2D.