Cardiovascular benefits of simultaneous pancreas-kidney transplant versus kidney alone transplant in diabetic patients

E. Orsenigo, C. Socci, P. Fiorina, V. Zuber, A. Secchi, V. Di Carlo, C. Staudacher

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Abstract

The aim of our study was to demonstrate the cardiovascular benefits of simultaneous pancreas-kidney transplantation when compared to kidney-alone transplants in diabetic recipients. Patients and methods. A total of 386 renal transplants were performed from 1985 to 2004, including 262 (68%) in diabetic recipients and 124 (32%) in nondiabetics. Among the former group, 200 kidneys were transplanted simultaneously to the pancreatic graft (KP group) and 62 were kidney-alone transplants (KA group). The mean time on dialysis was 31 ± 20 months (range 0-126 months). The duration of diabetes was 24 ± 7 years (range 5-51 years). Ninety-nine percent of the patients were on renal replacement therapy (79% on hemodialysis and 20% on peritoneal dialysis). Results. Among 262 patients, 28 (11%) died due to a cardiovascular event, which was higher among KA patients compared with the KP group (P = .004). Overall patient survival was significantly higher in the KP group when compared with the KA group (log-rank: P = .0004). Patient survivals were 80% and 70% versus 70% and 40% at 5 and 10 years in the KP and KA groups, respectively. Kidney graft survivals were 81% and 60% versus 63% and 26% at 5 and 10 years in the KP and KA groups, respectively. Pancreas graft survival was 70% and 50% at 5 and 10 years, respectively. Conclusions. This clinical evaluation, even if retrospective, confirmed that simultaneous pancreas-kidney transplantation has a protective effect against cardiovascular mortality in diabetic recipients affected by end-stage renal disease.

Original languageEnglish
Pages (from-to)3570-3571
Number of pages2
JournalTransplantation Proceedings
Volume37
Issue number8
DOIs
Publication statusPublished - Oct 2005

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Pancreas
Transplants
Kidney
Pancreas Transplantation
Graft Survival
Kidney Transplantation
Renal Replacement Therapy
Survival
Peritoneal Dialysis
Chronic Kidney Failure
Renal Dialysis
Dialysis
Mortality

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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Cardiovascular benefits of simultaneous pancreas-kidney transplant versus kidney alone transplant in diabetic patients. / Orsenigo, E.; Socci, C.; Fiorina, P.; Zuber, V.; Secchi, A.; Di Carlo, V.; Staudacher, C.

In: Transplantation Proceedings, Vol. 37, No. 8, 10.2005, p. 3570-3571.

Research output: Contribution to journalArticle

Orsenigo, E. ; Socci, C. ; Fiorina, P. ; Zuber, V. ; Secchi, A. ; Di Carlo, V. ; Staudacher, C. / Cardiovascular benefits of simultaneous pancreas-kidney transplant versus kidney alone transplant in diabetic patients. In: Transplantation Proceedings. 2005 ; Vol. 37, No. 8. pp. 3570-3571.
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abstract = "The aim of our study was to demonstrate the cardiovascular benefits of simultaneous pancreas-kidney transplantation when compared to kidney-alone transplants in diabetic recipients. Patients and methods. A total of 386 renal transplants were performed from 1985 to 2004, including 262 (68{\%}) in diabetic recipients and 124 (32{\%}) in nondiabetics. Among the former group, 200 kidneys were transplanted simultaneously to the pancreatic graft (KP group) and 62 were kidney-alone transplants (KA group). The mean time on dialysis was 31 ± 20 months (range 0-126 months). The duration of diabetes was 24 ± 7 years (range 5-51 years). Ninety-nine percent of the patients were on renal replacement therapy (79{\%} on hemodialysis and 20{\%} on peritoneal dialysis). Results. Among 262 patients, 28 (11{\%}) died due to a cardiovascular event, which was higher among KA patients compared with the KP group (P = .004). Overall patient survival was significantly higher in the KP group when compared with the KA group (log-rank: P = .0004). Patient survivals were 80{\%} and 70{\%} versus 70{\%} and 40{\%} at 5 and 10 years in the KP and KA groups, respectively. Kidney graft survivals were 81{\%} and 60{\%} versus 63{\%} and 26{\%} at 5 and 10 years in the KP and KA groups, respectively. Pancreas graft survival was 70{\%} and 50{\%} at 5 and 10 years, respectively. Conclusions. This clinical evaluation, even if retrospective, confirmed that simultaneous pancreas-kidney transplantation has a protective effect against cardiovascular mortality in diabetic recipients affected by end-stage renal disease.",
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