Long-Term survival after kidney and Kidney-Pancreas transplantation in diabetic patients

E. Orsenigo, P. Fiorina, M. Cristallo, C. Socci, E. La Rocca, P. Maffi, L. Invernizzi, V. Zuber, A. Secchi, V. Di Carlo

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To investigate the influence of diabetes mellitus on patient and graft survival among renal versus renal-pancreatic recipients. Methods Among 270 renal transplants performed from 1985 to 2002, a total of 204 (75%) were in diabetic patients and 66 (25%) in nondiabetic patients. Among the 204 diabetic patients 161 (60%) kidneys were transplanted simultaneously with a pancreatic graft (SKPT group). The overall group of patient included 164 (61%) men and 106 (39%) women with mean time on dialysis of 31 ± 21 months (range 0 to 126 months). The mean duration of diabetes was 24 ± 7 years (range 5 to 51 years). Ninety-nine percent of the patients were on renal replacement therapy (79% hemodialysis and 20% peritoneal dialysis). Results The overall rejection rate was similar (NS). Both patient and kidney graft survival rates were worse in diabetics. Patient survival was 82% at 5 years among patients undergoing SKPT, 60% in diabetics receiving only a kidney, and 88% in nondiabetic transplanted patients. Kidney graft survival at 5 years was 77% in diabetics receiving SKPT, 68% in diabetics receiving a kidney alone, and 82% in nondiabetic patients. Overall patient survival was significantly greater among nondiabetics (P = .002) or in diabetics who received SKPT compared with diabetics who only had a kidney transplant (P = .001). Conclusions This retrospective clinical evaluation confirms that combined pancreas and kidney transplantation should be the first choice to insulin-dependent diabetes mellitus (IDDM) patients with end-stage diabetic nephropathy.

Original languageEnglish
Pages (from-to)1072-1075
Number of pages4
JournalTransplantation Proceedings
Volume36
Issue number4
DOIs
Publication statusPublished - May 2004

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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