PMID- 23407544
OWN - NLM
STAT- MEDLINE
DCOM- 20130606
LR  - 20220331
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 95
IP  - 8
DP  - 2013 Apr 27
TI  - Combined pancreas-kidney transplantation for patients with end-stage nephropathy 
      caused by type-2 diabetes mellitus.
PG  - 1030-6
LID - 10.1097/TP.0b013e3182861945 [doi]
AB  - BACKGROUND: Simultaneous pancreas-kidney (SPK) transplantation is widely accepted 
      as an optimal therapeutic option for patients with type 1 diabetes mellitus 
      (T1DM) and end-stage renal disease, but the indication for patients with type 2 
      diabetes mellitus (T2DM) is still controversially discussed. METHODS: Twenty-one 
      T2DM recipients of a first combined pancreas-kidney graft performed at our center 
      during a 9-year period were retrospectively analyzed with regard to demographic 
      characteristics; cardiovascular risk factors; surgical, immunological, and 
      infectious complications; and patient and graft survivals and compared with T1DM 
      recipients (n=195) and 32 T2DM patients who received a kidney transplant alone 
      (KTA) during the same period. RESULTS: Patient survival at 1 and 5 years was 
      96.9% and 91.6% for the T1DM group, 90.5% and 80.1% for the T2DM group, and 87.1% 
      and 54.2% for the T2DM KTA group, respectively (P<0.001). Actuarial pancreas 
      graft survival for SPK recipients at 1 and 5 years was calculated to be 92.6% and 
      80.7% for the T1DM group and 81.0% and 75.9% for the T2DM group, respectively 
      (P=0.19). Kidney allograft survival at 5 years was 83.6% for T1DM, 80.4% for 
      T2DM, and 52.7% for T2DM KTA (P<0.0001). Multivariate analysis adjusting for 
      donor and recipient age, secondary complications of diabetes, body mass index, 
      waiting time, cold ischemic time, delayed graft function, and coronary risk 
      factors showed that differences did not remain statistically significant. 
      CONCLUSION: Favorable results can be achieved with SPK transplantation in type 2 
      diabetics with a low coronary risk profile. A high cardiac death rate impacts 
      results of KTA and calls for stringent selection.
FAU - Margreiter, Christian
AU  - Margreiter C
AD  - Department of Visceral, Transplant, and Thoracic Surgery, Innsbruck Medical 
      University, Austria. christian.margreiter@uki.at
FAU - Resch, Thomas
AU  - Resch T
FAU - Oberhuber, Rupert
AU  - Oberhuber R
FAU - Aigner, Felix
AU  - Aigner F
FAU - Maier, Herbert
AU  - Maier H
FAU - Sucher, Robert
AU  - Sucher R
FAU - Schneeberger, Stefan
AU  - Schneeberger S
FAU - Ulmer, Hanno
AU  - Ulmer H
FAU - Bosmuller, Claudia
AU  - Bosmuller C
FAU - Margreiter, Raimund
AU  - Margreiter R
FAU - Pratschke, Johann
AU  - Pratschke J
FAU - Ollinger, Robert
AU  - Ollinger R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
SB  - IM
MH  - Adult
MH  - Aged
MH  - Diabetes Mellitus, Type 2/complications/mortality/*surgery
MH  - Diabetic Nephropathies/etiology/mortality/*surgery
MH  - Female
MH  - Graft Survival
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Kidney Failure, Chronic/etiology/mortality/*surgery
MH  - Kidney Transplantation/*methods
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Pancreas Transplantation/*methods
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Young Adult
EDAT- 2013/02/15 06:00
MHDA- 2013/06/07 06:00
CRDT- 2013/02/15 06:00
PHST- 2013/02/15 06:00 [entrez]
PHST- 2013/02/15 06:00 [pubmed]
PHST- 2013/06/07 06:00 [medline]
AID - 10.1097/TP.0b013e3182861945 [doi]
PST - ppublish
SO  - Transplantation. 2013 Apr 27;95(8):1030-6. doi: 10.1097/TP.0b013e3182861945.