Pancreas Transplant for T2DM

Abstract

Type 2 diabetes mellitus (T2DM) was once considered a contraindication to simultaneous pancreas-kidney transplant, a growing body of evidence has revealed that similar graft and patient survival can be achieved when compared to type 1 diabetes mellitus recipients. 146 cases of pancreas transplantation were included for study, with 115 (79%) for T1DM and 31 (21%) for T2DM. Pancreas transplantation for T2DM was mainly indicated for the uremic groups such as SPK (32%), PAK (19%) and PBK (42%). After pancreas transplantation, 106 (73%) patients suffered from complications, including 70 (48%) early complications before discharge and 79 (54%) late complication during follow-up period. There was no significant difference regarding the complications between T1DM and T2DM groups. Overall, rejection of pancreas graft occurred in 37 (25%) patients, including 27 (19%) acute rejection and 13 (9%) chronic rejection. Rejection rates were also of no significant difference between T1DM and T2DM groups. The graft loss occurred in 35 (30%) T1DM patients and 12 (39%) T2DM patients. Endocrine outcomes regarding fasting blood sugar and serum HbA1c before and after pancreas transplantation were of no significant difference between T1DM and T2DM groups. T2DM patients presented significantly higher levels of serum C-peptide either before or after pancreas transplantation, as compared with T1DM patients. There was no significant difference regarding the graft survival between T1DM and T1DM groups. In conclusion, outcomes for T2DM were similar to T1DM after pancreas transplantation. Therefore, pancreas transplantation could be an effective option to treat uremic T2DM patients without significant insulin resistance.