15 Years Experience of Pancreas Transplant at the ALTRA Southern Alberta Transplant Program.

Abstract

Diabetes results in microvascular and macrovascular complications such as nephropathy, retinopathy and cardiovascular disease. Pancreas transplantation restores metabolic derangement and reduces or halts some of these complications therefore improves patient survival. Simultaneous pancreas and kidney transplant (SPK) is the most common approach while pancreas transplant after kidney transplant (PAK) is increasingly performed. We report our 15 years experience with 87 pancreas transplant procedures in 81 diabetic patients at the ALTRA Southern Alberta Transplant Program in Canada (73 SPK and 14 PAK, 3 patients received repeat pancreas transplant). The patient characteristics between these two groups are similar. Pre-emptive kidney transplantation is a major advantage of living kidney donation as all except one patient in PAK group had pre-transplant dialysis comparing to an average of 849 days of pre-transplant dialysis in SPK group. There is good patient survival in two groups after a median follow-up of 8.3 years (90.0±9.5% in PAK vs 83.2±5.3% in SPK). Excellent 10-year graft survival is achieved in both groups in kidney (85.7±13.2% in PAK vs 71.2±6.3% in SPK) and pancreas (61.2±14.0% in PAK vs 62.6±6.8% in SPK).Figure: No Caption available.Biopsy proven acute rejection rate was low and similar between SPK and PAK. In conclusion, both SPK and PAK transplantation lead to excellent long term patient and graft survival in type I diabetic patients. Pre-emptive kidney transplantation is a major advantage of living kidney donation followed by pancreas transplantation. DISCLOSURES:Tibbles, L.: Grant/Research Support, Pfizer.