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

Abstract

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.

Pancreas before Kidney Transplant in Diabetic Patients with Uremia

“…Signi cant improvements in quality of life and better life expectancy make it in the longer term, a lifesaving procedure compared to waiting candidates 14 . For diabetic patients with ESRD, SPK has been a standard treatment to provide a healthier lifestyle without the burden of dialysis and insulin therapy 4,10 .…”

“…Pancreas graft allocation system may be different from country to country 1,4,10,15 . The new pancreas allocation system went into effect on October 30, 2014 in the America, run by Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) 15 .…”

“…Traditionally, pancreas transplant has been reserved for diabetic patients with end-stage renal disease (ESRD), undergoing simultaneous pancreas-kidney transplant (SPK), and previously receiving a kidney graft and pancreas after kidney transplant (PAK), or those with brittle diabetes without uremia, undergoing pancreas transplant alone (PTA) [1][2][3] . For patients with labile DM and ESRD, SPK would be a preferred treatment because it can simultaneously provide an insulin-free and dialysis-free life for patients during the same operation [4][5][6][7][8][9] . Nevertheless, SPK has also been claimed to have the best long-term outcome in diabetic cases with renal failure 10,11 .…”

Early intestinal complications following pancreas transplantation: lessons learned from over 300 cases – a retrospective single‐center study

“…Pancreas transplantation has been recognized as the standard treatment for improved glucose homeostasis in selected diabetic patients, particularly for those with end‐stage renal disease [1]. Throughout its history, recent years have been coined the “decade of decline” because of the decreased number of cases [2,3].…”

Pankreastransplantation – Klinik, Technik und histologische Beurteilung

“…21 %, so werden aktuell nach einem Jahr Werte von 98 % Patienten-und 89 % Pankreastransplantatüberleben angegeben [2]. Die erfolgreiche PTX führt neben einer signifikanten Verbesserung der Lebensqualität zu einer nahezu vollständigen Normalisierung des Glukosestoffwechsels [5][6][7]. Daraus resultiert eine Reduktion der kardiovaskulären Mortalität und somit ein Vorteil für das Langzeitüberleben der Patienten [8,9].…”