Simultaneous pancreas and kidney transplantation

Redfield, Robert; Scalea, Joseph R.; Odorico, Jon S.

doi:10.1097/mot.0000000000000146

Cited by 102 publications

(72 citation statements)

References 53 publications

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“…With the advances in surgical techniques, immunosuppression, management of graft rejection, and other related complications, SPK can now be performed successfully in the majority of patients, with the pancreatic graft survival rate comparable with those of kidney and liver transplants. 1 It is currently the predominant type of pancreas transplantation for diabetic patients with ESRD. 2 According to the International Pancreas Transplant Registry, among over 35 000 pancreas transplantations reported by the end of 2010, approximately 75% were SPK, 18% were pancreas after kidney transplantation (PAK), and 7% were pancreas transplantation alone.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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

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Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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“…Although there were irreversible complications due to prolonged hemodialysis or following immunosuppressive therapy in the posttransplant period, we observed improvements in patients' perceptions of their general health, social interaction, vitality, and energy [16,17].…”

Section: Discussionmentioning

confidence: 63%

The quality of life in type I diabetic patients with end‐stage kidney disease before and after simultaneous pancreas‐kidney transplantation: a single‐center prospective study

et al. 2019

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Summary Simultaneous pancreas‐kidney transplantation (SPKT) aimed at increasing the life expectancy for diabetic patients with end‐stage kidney disease (ESKD). However, the risks of surgery complications and immunosuppression therapy make it unclear if the SPKT positively impacts patient's quality of life (QoL). Using the Kidney Disease Quality of Life—Short‐Form Health Survey (KDQOL‐SF36) and Problems Areas in Diabetes (PAID) measurement tools, we compared the QoL of 57 patients on the pretransplant waiting list with that of 103 patients who had undergone SPKT. Posttransplantation patients were assessed within different time intervals (<1, 1–3, and >3 years). Mean KDQOL‐SF36 scores were better among posttransplantation patients in the SF36 and KDQOL domains. It was also observed patients’ stress reduction in PAID mean score (P = 0.011) after SPKT. We concluded that patients receiving SPKT had a better perception of QoL than did patients on the waiting list, and this positive perception remained almost entirely comparable over the three different intervals of the posttransplantation time. These positive results showed better outcomes when excluding patients that lost pancreas graft function. Further research is needed to compare diabetic patients with kidney transplant alone using specific measurement tools to evaluate patient's QoL.

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“…Of those, 40 met our inclusion criteria of two functional allografts with no treatment for rejection between the biopsies, or if rejection was treated, the biopsies were within 4 days of each other. Biopsies were excluded because either the pancreas (15), kidney (6), or both organs had been explanted (7), because the kidney was biopsied at the time of transplant reperfusion (6), because treatment was given more than 4 days before the kidney (8) or pancreas (6) biopsy, or because the kidney and pancreas were from different donors (3) ( Fig. 1).…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Concurrent biopsies of both grafts in recipients of simultaneous pancreas and kidney demonstrate high rates of discordance for rejection as well as discordance in type of rejection - a retrospective study

et al. 2017

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It is commonly assumed that in simultaneous pancreas and kidney (SPK) recipients, rejection of the two organs is concordant. As a result, concurrent biopsies of both organs are rarely performed and there are limited histological data on how often rejection is in fact discordant. We reviewed all SPK recipients transplanted at the University of Wisconsin between January 01, 2001, and December 31, 2016, that underwent biopsy of both organs. We included all patients whose biopsies were within 30 days. If patients were treated for rejection between biopsies, they were excluded if the biopsies were more than 4 days apart. Ninety-one simultaneous biopsies were performed within 30 days of each other, and 40 met our inclusion criteria. A total of 25 (62.5%) patients had concordance of biopsy findings: 11 had rejection of both organs, and 14 had no rejection of either organ. The other 15 (37.5%) were discordant for rejection, with 10 having pancreas-only rejection and five kidney-only rejection. It was striking to find that four of the 11 patients with concordance for rejection (36%) had different types (AMR, ACR, or mixed) of rejection in the two organs. This large series of simultaneous pancreas and kidney biopsies demonstrates the continued utility of performing biopsies of both organs.

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Simultaneous pancreas and kidney transplantation

Cited by 102 publications

References 53 publications

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

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

The quality of life in type I diabetic patients with end‐stage kidney disease before and after simultaneous pancreas‐kidney transplantation: a single‐center prospective study

Concurrent biopsies of both grafts in recipients of simultaneous pancreas and kidney demonstrate high rates of discordance for rejection as well as discordance in type of rejection - a retrospective study

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