Kidney plus pancreas transplant best for diabetics
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People with type 1 diabetes who need a kidney transplant, as many do, fare better over the long term when they receive a pancreas transplant at the same time, according to researchers from the University of Heidelberg in Germany.
“Our study shows that a functioning pancreas has a benefit for the simultaneously transplanted kidney,” lead investigator Dr. Christian Morath said in a statement. “At the same time, this procedure prolongs the survival of the patient, compared to a patient who received only a kidney transplant.”
The reason for the improved survival with simultaneous pancreas-and-kidney transplantation is not fully known, but likely relates to the enhanced glucose control achieved with the combined procedure, the researchers note in the Journal of the American Society of Nephrology.
The study involved 2190 patients given a living-donor kidney, 5705 deceased-donor kidney recipients, and 3525 patients undergoing simultaneous pancreas-and-kidney transplantation.
Compared with the other groups, the deceased-donor kidney group had inferior survival rates, the report indicates, a finding that is consistent with prior research.
Initially, the pancreas-and-kidney group had worse survival than did the living-donor kidney group, but the pancreas-and-kidney group’s rate eventually caught up, and beyond 10 years survival was higher.
In fact, after 10 years, the risk of dying for pancreas-and-kidney recipients was 45 percent lower than for living-donor kidney patients.
“Based on these results, we feel that all type 1 diabetics with kidney failure should be considered for simultaneous pancreas-kidney transplantation,” Dr. Morath concluded.
SOURCE: Journal of the American Society of Nephrology, online May 21, 2008.
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