Simultaneous Pancreas and Kidney Transplantation—Is It a Treatment Option for Patients With Type 2 Diabetes Mellitus? An Analysis of the International Pancreas Transplant Registry
- 777 Downloads
Purpose of Review
Pancreas transplantation remains the best long-term treatment option to achieve euglycemia and freedom from insulin in patients with labile diabetes mellitus. It is an approved procedure for type 1 (T1DM), but it is still considered controversial for type 2 diabetes mellitus (T2DM).
This study analyzed all primary deceased donor pancreas transplants in patients with T2DM reported to IPTR/UNOS between 1995 and 2015. Characteristics, outcomes, and risk factors over time were determined using univariate and multivariate methods. The focus was on simultaneous pancreas/kidney (SPK) transplants, the most common pancreas transplant category. Patient, pancreas, and kidney graft survival rates increased significantly over time and reached 95.8, 83.3, and 91.1%, respectively, at 3 years posttransplant for transplants performed between 2009 and 2015.
SPK is a safe procedure with excellent pancreas and kidney graft outcome in patients with T2DM. The procedure restores euglycemia and freedom from insulin and dialysis. Based on our results, SPK should be offered to more uremic patients with labile T2DM.
KeywordsPancreas transplants Kidney transplants Patient survival Graft function Type 2 diabetes mellitus Risk factors
Compliance With Ethical Standards
Conflict of Interest
Angelika C. Gruessner, Mark R. Laftavi, Oleh Pankewycz, and Rainer W.G. Gruessner declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.• American Diabetes A. 2. Classification and diagnosis of diabetes. Diabetes Care. 2016;39(Suppl 1):S13–22. Helpful new guidelines for the classification of diabetes type. Google Scholar
- 11.•• Gruessner AC, Gruessner RW. Pancreas transplantation of US and non-US cases from 2005 to 2014 as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR). Rev Diabet Stud. 2016;13(1):35–58. Newest overview over the development of pancreas transplantation. CrossRefPubMedGoogle Scholar
- 18.• Neidlinger N, et al. Incidence of and risk factors for posttransplant diabetes mellitus after pancreas transplantation. Am J Transplant. 2010;10(2):398–406. This work provides a nice overview about risk factors for post-transplant diabetes mellitus which is especially important for patients with T2DM. CrossRefPubMedGoogle Scholar