Abstract
Pancreas transplantation is considered a therapeutic option for patients with complicated diabetes mellitus. In this study, we compared survival rate between patients on the waiting list for pancreas transplant alone(PTA), simultaneous pancreas–kidney(SPK) transplant, and pancreas after kidney(PAK) transplant and transplant recipients. A total of 503 patients (PTA:n = 116; SPK:n = 303; PAK:n = 84) and 280 PT recipients (PTA:n = 89; SPK:n = 155; PAK:n = 36) were retrospectively analyzed at our center between February 2000 and December 2015; 11.9%(60/503) of the patients on the waiting list and 4.3%(12/280) of the PT recipients died. The overall survival rate was higher in the waiting list group for the first year (99.3% vs. 97.8%), after which it was significantly higher in PT group (p = 0.039). The overall relative risk of all-cause mortality for transplant recipients was 2.145(p = 0.285) for PTA, 0.688(p = 0.735) for PAK, however,0.361 (p = 0.012) for SPK compared with that for the waiting list patients. SPK transplant recipients had considerable higher survival benefits, despite the relatively long waiting period, especially after 1 year. In addition, PTA and PAK can also be considered as a treatment option as patient survival was not poor.
Highlights
It has been well established that the worldwide prevalence of diabetes mellitus (DM) has steadily increased[1,2]
The patients were subdivided according to the transplant type [pancreas transplant alone (PTA), simultaneous pancreas–kidney (SPK) transplant, or pancreas after kidney (PAK) transplant]
Between February 2000 and December 2015, 116 (23.1%), 303 (60.2%), and 84 (16.7%) patients were on the waiting list for PTA, SPK, and PAK transplants, respectively
Summary
It has been well established that the worldwide prevalence of diabetes mellitus (DM) has steadily increased[1,2]. Various complications, such as retinopathy and neuropathy, are associated with blood glucose levels and can increase mortality and morbidity rate. Pancreas transplantation (PT) is considered an acceptable therapeutic option for restoring normoglycemia by supplying sufficient β cells. This was made possible by improvement in both patient and graft survival and postoperative management as well as decrease in postoperative morbidity due to technological progress and development of immunosuppressants[5,6].
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