Patient, kidney, and pancreas survival in pancreas after kidney transplantation<i>versus</i>simultaneous pancreas and kidney transplantation: meta-analysis

Xue, Wenrui; Huang, Zhen; Hu, Xiaopeng

doi:10.1093/bjsopen/zrac108

Cited by 3 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Simultaneous pancreas‐kidney transplantation (SPK) offers patients with diabetic nephropathy superior survival compared to kidney transplantation from either deceased or living donors 1 . Patients with SPK also have better pancreas graft and long‐term survival than those that undergo pancreas after kidney (PAK) transplantation, although kidney graft survival is superior in PAK 2 . SPK also improves quality of life in diabetic patients, but complications requiring reoperation are common 3,4 …”

Section: Introductionmentioning

confidence: 99%

“…1 Patients with SPK also have better pancreas graft and long-term survival than those that undergo pancreas after kidney (PAK) transplantation, although kidney graft survival is superior in PAK. 2 SPK also improves quality of life in diabetic patients, but complications requiring reoperation are common. 3,4 Finland has the highest incidence of type 1 diabetes mellitus (T1D) in the world (52.2/100 000/year) in children under the age of 15.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The first 10 years of simultaneous pancreas‐kidney transplantation in Finland

Ahopelto

Sallinen

Helanterä

et al. 2023

Clinical Transplantation

View full text Add to dashboard Cite

IntroductionSimultaneous pancreas‐kidney transplantation (SPK) is an option for patients with type 1 diabetes (T1D) and kidney failure but can be associated with a high complication rate. Here we describe our 10‐year experience since the launch of the SPK program.MethodsThis retrospective study included consecutive patients with T1D receiving SPK from March 14, 2010 to March 14, 2020 at Helsinki University Hospital. Portocaval anastomosis (i.e., systemic venous drainage) and enteric exocrine drainage were used. A specific team was trained for both pancreas retrieval and transplantation, postoperative care was standardized to include somatostatin analogues, antimicrobial treatment, and preoperatively initiated chemothrombopropylaxis. During program maturation donor criteria were expanded and logistical processes improved to minimize cold ischemia time. Clinical data were collected from a nationwide transplantation registry and patient records.ResultsA total of 166 SPKs were performed (median 2 per year in the first 3 years, 17.5 per year for the following 4 years, and 23 per year for the past 3 years). Seven patients (4.1%) died with a functioning graft with a median 43 months follow‐up. One‐year pancreas graft survival was 97.0%, 3‐year pancreas graft survival was 96.1% and 5‐year was 96.1%. Mean HbA1c was 36 mmol/mol (SD 5.57) and creatinine was 107 μmol/L (SD 34.69) at 1‐year after transplantation. All kidney grafts were functioning at the end of follow‐up. Complications required re‐laparotomy in 39 (23%) patients, mostly due to a pancreas graft related problem (N = 28). No pancreas or kidney graft failure from thrombosis occurred.ConclusionA planned, step‐wise development of an SPK program offers a safe and effective treatment for patients with T1D and kidney failure.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The first 10 years of simultaneous pancreas‐kidney transplantation in Finland

Ahopelto

Sallinen

Helanterä

et al. 2023

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…Simultaneous pancreas-kidney transplantation (SPK) offers superior survival over kidney transplantation only (or pancreas after kidney transplantation) to patients with type one diabetes (T1D) and end-stage kidney disease (ESKD) [ 1 , 2 ]. It improves the quality of life and life-expectancy compared to patients remaining on dialysis [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Pasireotide Versus Octreotide in Preventing Complications After Simultaneous Pancreas-Kidney Transplantation

Ahopelto

Bonsdorff

Räihä³

et al. 2023

Transpl Int

View full text Add to dashboard Cite

In elective pancreatic surgery, somatostatin-analogues pasireotide and octreotide are variably used to reduce postoperative complications, but knowledge on their role in pancreas transplantation is limited. This study compared pasireotide and octreotide for their association with complications after simultaneous pancreas-kidney transplantation (SPK). This retrospective study included consecutive patients undergoing SPK’s from July 2013 to July 2022. Between July 2013 and April 2020, octreotide was administered 0.1 mg s.c. once daily and between May 2020 and July 2022 pasireotide was administered 0.9 mg twice daily, both until third postoperative day. Complications within 90 days postoperatively were collected, and reoperation rate and Comprehensive Complication index (CCI) ≥ 33.7 (morbidity equal to one reoperation) were used as primary outcomes. Of the 213 patients undergoing SPK, 150 patients received octreotide and 63 pasireotide. Baseline characteristics were comparable. Reoperation rate was 25.3% (n = 38) and 17.5% (n = 11) (p = 0.213) and rate of CCI ≥ 33.7 was 40.7% (n = 61) and 30.2% (n = 19) (p = 0.148) in octreotide and pasireotide groups, respectively. When adjusted with donor BMI, pancreas donor risk index, and donor sex, receiving pasireotide translated into OR 0.49 (95% CI: 0.25–0.96 p = 0.037) for CCI ≥ 33.7. Pasireotide was independently associated with lower postoperative morbidity within 90 days of SPK compared to octreotide.

show abstract

Transplantationsmöglichkeiten für Patienten mit Diabetes und fortgeschrittener Niereninsuffizienz

Chatzikyrkou

2023

Diabetologie

View full text Add to dashboard Cite

Patient, kidney, and pancreas survival in pancreas after kidney transplantationversussimultaneous pancreas and kidney transplantation: meta-analysis

Cited by 3 publications

References 4 publications

The first 10 years of simultaneous pancreas‐kidney transplantation in Finland

The first 10 years of simultaneous pancreas‐kidney transplantation in Finland

Pasireotide Versus Octreotide in Preventing Complications After Simultaneous Pancreas-Kidney Transplantation

Transplantationsmöglichkeiten für Patienten mit Diabetes und fortgeschrittener Niereninsuffizienz

Contact Info

Product

Resources

About