Simultaneous pancreas-kidney transplantation: The role in the treatment of type 1 diabetes and end-stage renal disease

Abstract

Type 1 diabetes mellitus (DM) is one of the most common and debilitating diseases to affect the world. Many patients are afflicted by microvascular and macrovascular complications, and succumb to end-stage renal disease (ESRD). Although dialysis and insulin therapy provides better glycemic control, it nonetheless significantly decreases a patient's quality of life. Moreover, they cannot reverse ESRD or alleviate complications. Simultaneous pancreas-kidney (SPK) transplantation has revolutionized the way we manage type 1 DM; it provides a physiological means of achieving normoglycemia while rendering patients free of dialysis. Understanding this procedure is important because it is becoming a more common management strategy for patients with type 1 DM. In this review, we will begin with a brief summary of type 1 DM, followed by a comprehensive description of SPK procedure, including the history and technique. We will then present the outcomes of transplantation.

Simultaneous Pancreas-Kidney Transplantation From Living Donor Using Hand-Assisted Laparoscopic Donor Surgery: Single-Center Experience

“…Nephropathy is one of the most life-threatening complications, culminating in endstage renal disease) [1,2,8]. Even though tight glycemic control can slow the progress and reduce the risk of developing complications, it cannot sustain normoglycemia and stop the progression of diabetic complications [10]. SPK has been the fundamental treatment and has shown significant results in selected patients diagnosed with type 1 diabetes with renal insufficiency [2].…”

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 . There is evidence that of the routinely performed solid organ transplants, pancreas transplantation has the highest rate of complications .…”

Simultaneous en-bloc pancreas and kidney transplantation from a small pediatric donor after circulatory death

“…Simultaneous pancreas and kidney transplantation (SPKT) is an effective treatment option for patients with type 1 diabetes and end stage renal disease . Donor organ quality is directly related to transplantation outcomes; in pancreas transplantation, donor age and obesity are major determinants of successful transplantation .…”