Simultaneous pancreas and kidney transplantation as the standard surgical treatment for diabetes mellitus patients with end-stage renal disease

Abstract

Objectives: To review the outcome following simultaneous pancreas and kidney transplantation in patients with type 1 diabetes mellitus and endstage renal disease, as well as those with type 2 diabetes mellitus, and to discuss the applicability of this treatment in this locality. Methods:A systematic literature review was performed by searching the PubMed and Elsevier databases. The search terms used were "simultaneous pancreas and kidney transplantation", "diabetes", "pancreas transplant" and "SPK". Original and major review articles related to simultaneous pancreas and kidney transplantation were reviewed. Papers published in English after 1985 were included. Clinical outcomes following transplantation were extracted for comparison between different treatment methods. Outcomes of simultaneous pancreas and kidney transplant and other transplantation methods were identified and categorised into patient survival, graft survival, diabetic complications, and quality of life. Patient survivals and graft survivals were also compared. Results

Simultaneous pancreas and kidney transplantation for end-stage kidney disease patients with type 2 diabetes mellitus: a systematic review and meta-analysis

“…The survival estimates of pancreas graft should be interpreted with caution given the various definitions reported in each program. Even though UNOS approved a standard definition in 2015 and the new policy was implemented in 2018, these were not reflected in the included studies [34][35][36].…”

An audit of pregnancy outcomes in solid organ transplant recipients at a metropolitan hospital

“…SPK transplant is now the worldwide standard treatment in patients with end‐stage renal disease with type I diabetes mellitus . Generally the pancreas and kidney are transplanted with an intraperitoneal approach into contralateral iliac fossae .…”

Management of Graft Duodenal Leak in Simultaneous Pancreas Kidney Transplant—a Case Report from India and Review of Literature

“…Over the last few decades, SPK transplantation has emerged as a standard treatment of patients with end-stage renal disease resulting from Type 1 diabetes mellitus [1]. According to the International Pancreas Transplant Registry, over 35,000 pancreas transplants have been reported by the end of 2010.…”

“…Pancreatic transplantation is currently the only effective cure for Type 1 diabetes mellitus, allowing long-term glycemic control without exogenous insulin and amelioration of secondary diabetic complications [1]. In patients with Type 1 diabetes complicated by end-stage renal disease, a simultaneous pancreas and kidney transplantation (SPK) can significantly improve their quality of life and long-term survival [2].…”