Simultaneous pancreas kidney transplants in diabetic patients with end‐stage renal disease: the 20‐yr experience

Light, Jimmy A.; Tucker, M. J.

doi:10.1111/ctr.12100

Cited by 44 publications

(39 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When data were stratified by diabetes mellitus type, there was no observed difference in patient or pancreatic graft survival [ 39 ]. Long-term (20-year) data from the Light et al [ 38 ▪▪ ] series also suggest similar patient and graft survival regardless of diabetes type after risk stratification. In another single-center review of SPK transplants from Europe published in 2013, authors identified 21 patients of 216 who were transplanted for a diagnosis of T2DM [ 46 ].…”

Section: Type 2 Diabetesmentioning

confidence: 88%

“…Complicating its clinical utility, fasting C-peptide levels may be falsely high in patients with CKD and/or gastroparesis [ 37 ]. Additionally, C-peptide is not always positive in the T2DM patients, further confounding the diagnosis [ 38 ▪▪ , 39 ]. There is a clear need for more precise, multiparameter or genetic categorizations of T1DM, T2DM, and/or other forms of diabetes before transplantation.…”

Section: Type 2 Diabetesmentioning

confidence: 99%

See 1 more Smart Citation

Simultaneous pancreas and kidney transplantation

Redfield¹,

Scalea²,

Odorico³

2015

Current Opinion in Organ Transplantation

105

View full text Add to dashboard Cite

Purpose of reviewImportant trends are being observed in pancreas transplantation in the USA. We will describe recent trends in simultaneous pancreas kidney (SPK) transplantation related to immunosuppression, treatment of rejection, and transplantation for patients of advanced age and C-peptide positive diabetes.Recent findingsRates of pancreas transplantation have declined, despite improved pancreatic graft outcomes. Regarding immunosuppression, trends in SPK transplantation include T-cell depletion induction therapy, waning mammalian target of rapamycin inhibitor use and steroid use in greater than 50% of pancreas transplant recipients with few patients undergoing late steroid weaning. Rejection of the pancreas may be discordant with the kidney after SPK and there is a greater appreciation of antibody-mediated rejection of the pancreas allograft. De-novo donor-specific antibody without graft dysfunction remains an active area of study, and the treatment for this condition is unclear. SPKs are being performed with greater frequency in type 2 diabetes mellitus patients and in patients of advanced age, with exemplary results.SummaryThe current state of the art in SPK transplantation is yielding superb and improving results.

show abstract

Section: Type 2 Diabetesmentioning

confidence: 88%

Section: Type 2 Diabetesmentioning

confidence: 99%

Simultaneous pancreas and kidney transplantation

Redfield¹,

Scalea²,

Odorico³

2015

Current Opinion in Organ Transplantation

105

View full text Add to dashboard Cite

show abstract

“…Recently, two studies support the option of SPK for type 2 diabetic patients. Long-term data suggest similar patient and graft survival regardless of diabetes type after risk stratification [ 39 ]. In another single-center review of 216 SPK transplants from Europe, 21 of them had a diagnosis of type 2 diabetes [ 40 ].…”

Section: Results Of Transplantation In Type 2diabetic Patientsmentioning

confidence: 99%

Kidney Transplantation in the Diabetic Patient

Pérez‐Sáez

Pascual

2015

JCM

View full text Add to dashboard Cite

Diabetes mellitus is one of the most important causes of chronic kidney disease (CKD). In patients with advanced diabetic kidney disease, kidney transplantation (KT) with or without a pancreas transplant is the treatment of choice. We aimed to review current data regarding kidney and pancreas transplant options in patients with both type 1 and 2 diabetes and the outcomes of different treatment modalities. In general, pancreas transplantation is associated with long-term survival advantages despite an increased short-term morbidity and mortality risk. This applies to simultaneous pancreas kidney transplantation or pancreas after KT compared to KT alone (either living donor or deceased). Other factors as living donor availability, comorbidities, and expected waiting time have to be considered whens electing one transplant modality, rather than a clear benefit in survival of one strategy vs. others. In selected type 2 diabetic patients, data support cautious utilization of simultaneous pancreas kidney transplantation when a living kidney donor is not an option. Pancreas and kidney transplantation seems to be the treatment of choice for most type 1 diabetic and selected type 2 diabetic patients.

show abstract

“…The C peptide cut-off is another source of debate, since it does not fully correlate with diabetes type 38,39 , and C peptide levels do not predict outcome 40,41 ; prompting some to propose raising the cut-off to 10 ng/ml to include more T2DM patients 34 .…”

Section: Pancreas Transplantationmentioning

confidence: 99%

β Cell Replacement Therapy

et al. 2018

View full text Add to dashboard Cite

β cell replacement with either pancreas or islet transplantation has progressed immensely over the last decades with current 1- and 5-year insulin independence rates of approximately 85% and 50%, respectively. Recent advances are largely attributed to improvements in immunosuppressive regimen, donor selection, and surgical technique. However, both strategies are compromised by a scarce donor source. Xenotransplantation offers a potential solution by providing a theoretically unlimited supply of islets, but clinical application has been limited by concerns for a potent immune response against xenogeneic tissue. β cell clusters derived from embryonic or induced pluripotent stem cells represent another promising unlimited source of insulin producing cells, but clinical application is pending further advances in the function of the β cell like clusters. Exciting developments and rapid progress in all areas of β cell replacement prompted a lively debate by members of the young investigator committee of the International Pancreas and Islet Transplant Association at the 15th International Pancreas and Islet Transplant Association Congress in Melbourne and at the 26th international congress of The Transplant Society in Hong Kong. This international group of young investigators debated which modality of β cell replacement would predominate the landscape in 10 years, and their arguments are summarized here.

show abstract

Simultaneous pancreas kidney transplants in diabetic patients with end‐stage renal disease: the 20‐yr experience

Abstract: Despite the differences between groups by BMI, age of onset of insulin use, and age at transplant, there was a difference in patient but not graft survival within the 20 yr follow-up period.

Cited by 44 publications

References 16 publications

Simultaneous pancreas and kidney transplantation

Simultaneous pancreas and kidney transplantation

Kidney Transplantation in the Diabetic Patient

β Cell Replacement Therapy

Contact Info

Product

Resources

About