Kidney Graft and Patient Survival With and Without a Simultaneous Pancreas Utilizing Contralateral Kidneys From the Same Donor

Metabolic Control Improves Long-Term Renal Allograft and Patient Survival in Type 1 Diabetes

“…Numerous studies have compared graft and patient survival in DDK and SPK recipients and found conflicting results. [2][3][4][5][6][7][8][9]12,13 The differing outcomes can be attributed to different transplantation characteristics: In general, SPK transplantation is associated with more favorable donor characteristics, because most transplant centers accept only pancreas allografts obtained from young (i.e., younger than 40 yr), healthy donors. Furthermore, SPK recipients are on average younger and are in generally better physical condition.…”

“…Furthermore, SPK recipients are on average younger and are in generally better physical condition. An approach to account for these confounders was recently published: Waki et al 9 compared the results of DDK and SPK from the same deceased donor. When the donor-specific variables were stratified in this manner, graft and patient survival did not differ between DDK and SPK; however, this approach did not stratify for the influence of recipient factors, and follow-up was short.…”

“…4 -8 In a recent analysis of SPK and kidney transplantation alone, comparing transplants in which one patient with diabetes received an SPK and a second patient with diabetes received the contralateral kidney from the same deceased donor but without a concurrent pancreas, there was no difference between the two groups of recipients in terms of kidney graft and patient survival up to 9 yr of follow-up. 9 Whether microvascular lesions improve in patients who have type 1 diabetes and receive an SPK transplant is discussed controversially. In recipients of single pancreas transplants, regression of diabetic kidney lesions in the native kidneys has been documented after the fifth year of posttransplantation follow-up in a biopsy-controlled study.…”

Sham Surgery

“…For example, Waki and colleagues studied the putative survival benefit of pancreas transplantation in an ingenious but straightforward way [15]. They queried a large transplant database for deceased organ donors who had donated one of their kidneys to a diabetic recipient as part of a simultaneous pancreas-kidney transplant (SPK), and the other kidney to a diabetic recipient as a kidney graft alone-a "sham" (absent pancreas) SPK.…”

Pancreatic Anastomosis Leak 15 Years After Simultaneous Pancreas-Kidney Transplantation From Late-Onset Allograft Cytomegalovirus Duodenal Ulcers Presenting With Gross Hematuria

“…It can improve longevity and quality of life for diabetic patients. 1 However, morbidity and mortality post-transplantation result from medical complications from immunosuppression and opportunistic infection as well as surgical complications from surgical anastomosis. Both medical and surgical complications generally occur in the early post-transplant period when the patients have a high level of immunosuppression.…”