Combo Kidney-Pancreas Transplant Boosts Survival in Diabetics
WEDNESDAY, May 21 -- Compared to kidney transplantation alone, a simultaneous kidney-pancreas transplant improves the likelihood of long-term survival in patients with type 1 diabetes and end-stage renal disease (ESRD), according to a German study.
The researchers analyzed the long-term outcomes of more than 11,000 patients with type 1 diabetes and ESRD who had a kidney transplant between 1984 and 2000, including 3,500 who had simultaneous kidney-pancreas transplantation. In some cases, patient and transplanted kidney survival were evaluated up to 18 years after the transplant.
After adjusting for other factors, the researchers concluded that patients who received simultaneous kidney-pancreas transplants had better long-term survival. Beyond 10 years, the risk of death in the kidney-pancreas group was 45 percent lower than in the kidney group.
That improved long-term survival was largely the result of a lower risk of cardiovascular disease -- 37 percent among kidney-pancreas patients compared with 46 percent to 49 percent in kidney-only patients.
"Based on these results, we feel that all type 1 diabetics with kidney failure should be considered for simultaneous pancreas-kidney transplantation," Dr. Christian Morath, of the University of Heidelberg, said in a prepared statement.
The study appears in the August issue of the Journal of the American Society of Nephrology.
"Our study shows that a functioning pancreas has a benefit for the simultaneously transplanted kidney," Morath said. "At the same time, this procedure prolongs the survival of the patient, compared to a patient who received only a kidney transplant."
Morath said the lower risk of cardiovascular death among kidney-pancreas transplant patients "is most likely due to the [normal blood sugar levels] in patients who received a combined treatment."
The results "show an interaction of different and independent organs -- kidney, pancreas, and heart -- with respect to survival of the patient."
The National Kidney Foundation has more about kidney transplantation.
Posted: May 2008
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