Simultaneous Pancreas/Kidney Transplant versus Kidney Transplantation Alone

Researchers at Tianjin First Central Hospital, Tianjin, China, led by X. Y. Fu, conducted a study to compare renal function, metabolic profiles, and survival outcomes among patients with end-stage kidney disease (ESKD) and diabetes mellitus undergoing simultaneous pancreas kidney transplantation (SPK) with those undergoing kidney transplantation alone. Results of the study were reported during a virtual session at the 2021 American Transplant Congress. The presentation was titled Superior Metabolic Function of Type 2 Diabetes Mellitus Patients after Simultaneous Kidney/Pancreas Transplantation compared with Kidney Transplantation Alone.

The researchers retrospectively analyzed data on patients with ESKD and type 2 diabetes who underwent SPK (n=85) or kidney transplantation alone (n=71). Data on demographics, perioperative parameters, postoperative blood glucose and lipid profiles, complications, and survival outcomes in the two cohorts were analyzed. Mixed effects models were used to compare data between the cohorts.

In general, patients in the SPK group were younger than those in the kidney transplantation alone group (mean, 49.01 years vs 52.14 years; P=.018); donor age in the SPK group was also younger than in the kidney transplantation alone group (mean, 32.1 years vs 47.14 years; P<.001).

Renal function and metabolic outcomes were superior in the SPK group compared with the kidney transplantation alone group, including higher estimated glomerular filtration rate (P=.393), lower fasting serum glucose level (P<.001), lower triglyceride level (P=.0439), and lower cholesterol level (P=.002). The rate of infection was higher in the SPK cohort than in the kidney transplantation alone cohort (38% vs 22.4%, respectively; P=.003). There were no significant differences between the two cohorts in survival outcomes.

In conclusion, the researchers said, “SPK provides better renal function and metabolic outcomes, but has higher rate of infection than kidney transplantation alone for ESKD-type 2 diabetes mellitus patients. The 5-year survival outcomes of recipients and grafts were comparable between the two groups.”

Source: Fu X Y, YU C, Wang H, et al. Superior metabolic function of type 2 diabetes mellitus patients after simultaneous kidney/pancreas transplantation compared with kidney transplantation alone. Abstract of a presentation at the virtual 2021 American Transplant Congress (Abstract #896), June 5, 2021.