PMID- 22344508
OWN - NLM
STAT- MEDLINE
DCOM- 20120807
LR  - 20120411
IS  - 1555-905X (Electronic)
IS  - 1555-9041 (Linking)
VI  - 7
IP  - 4
DP  - 2012 Apr
TI  - Simultaneous pancreas kidney transplant versus other kidney transplant options in 
      patients with type 2 diabetes.
PG  - 656-64
LID - 10.2215/CJN.08310811 [doi]
AB  - BACKGROUND AND OBJECTIVES: Current organ allocation policy prioritizes placement 
      of kidneys (with pancreas) to patients listed for simultaneous pancreas-kidney 
      transplantation (SPK). Patients with type 2 diabetes mellitus (T2DM) may undergo 
      SPK, but it is unknown whether these patients enjoy a survival advantage with SPK 
      versus deceased-donor kidney transplantation alone (DDKA) or living-donor kidney 
      transplantation alone (LDKA). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: 
      Using the Scientific Registry of Transplant Recipients database, patients with 
      T2DM, age 18-59 years, body mass index 18-30 kg/m(2), who underwent SPK, DDKA, or 
      LDKA from 2000 through 2008 were identified. Five-year patient and kidney graft 
      survival rates were compared, and multivariable analysis was performed to 
      determine donor, recipient, and transplant factors influencing these outcomes. 
      RESULTS: Of 6416 patients identified, 4005, 1987, and 424 underwent DDKA, LDKA, 
      and SPK, respectively. On unadjusted analysis, patient and kidney graft survival 
      rates were superior for LDKA versus SPK, whereas patient but not graft survival 
      was higher for SPK versus DDKA. On multivariable analysis, survival advantage for 
      SPK versus DDKA was related not to pancreas transplantation but younger donor and 
      recipient ages in the SPK cohort. CONCLUSIONS: Good outcomes can occur with SPK 
      in selected patients with T2DM, but no patient or graft survival advantage is 
      provided by added pancreas transplantation compared with DDKA; outcomes were 
      superior with LDKA. These results support cautious use of SPK in T2DM when LDKA 
      is not an option, with close oversight of the effect of kidney (with pancreas) 
      allocation priority over other transplant candidates.
FAU - Wiseman, Alexander C
AU  - Wiseman AC
AD  - Division of Renal Diseases and Hypertension, University of Colorado Denver, 
      Aurora, 80045, USA. Alexander.wiseman@ucdenver.edu
FAU - Gralla, Jane
AU  - Gralla J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20120216
PL  - United States
TA  - Clin J Am Soc Nephrol
JT  - Clinical journal of the American Society of Nephrology : CJASN
JID - 101271570
SB  - IM
CIN - Clin J Am Soc Nephrol. 2012 Apr;7(4):530-2. PMID: 22442186
MH  - Adolescent
MH  - Adult
MH  - Chi-Square Distribution
MH  - Child
MH  - Child, Preschool
MH  - Diabetes Mellitus, Type 2/mortality/*surgery
MH  - Female
MH  - Graft Survival
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Kaplan-Meier Estimate
MH  - *Kidney Transplantation/adverse effects/mortality
MH  - Living Donors
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - *Pancreas Transplantation/adverse effects/mortality
MH  - Patient Selection
MH  - Proportional Hazards Models
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
MH  - Young Adult
EDAT- 2012/02/22 06:00
MHDA- 2012/08/08 06:00
CRDT- 2012/02/21 06:00
PHST- 2012/02/21 06:00 [entrez]
PHST- 2012/02/22 06:00 [pubmed]
PHST- 2012/08/08 06:00 [medline]
AID - CJN.08310811 [pii]
AID - 10.2215/CJN.08310811 [doi]
PST - ppublish
SO  - Clin J Am Soc Nephrol. 2012 Apr;7(4):656-64. doi: 10.2215/CJN.08310811. Epub 2012 
      Feb 16.