Patients with Type 1 diabetes who need a kidney transplant, have a better survival rate when they get a simultaneous pancreas-kidney (SPK) transplant compared to other transplant options. A recent study by researchers at the University of Colorado Denver School of Medicine shows a functional pancreas transplant is critical for these improved results. The study is published in this month’s Clinical Journal of the American Society of Nephrology (CJASN).
“This study helps patients with Type 1 diabetes and their doctors decide upon the best transplant treatment option,” comments Alexander Wiseman, MD, associate professor, Division of Renal Diseases and Hypertension at the University of Colorado Denver School of Medicine and medical director of Kidney and Pancreas Transplant Program at the University of Colorado Hospital.
The study included nearly 6,900 Type 1 diabetics undergoing SPK transplantation. When SPK transplant was successful with both organs functional at one year, the long-term survival rate was 89 percent, compared to 80 percent for patients receiving a kidney from a living donor and 65 percent for those receiving a kidney (but not pancreas) from a deceased donor (All SPK transplants came from deceased donors). However, SPK recipients were about two percent more likely to die during the first year after transplantation. There also was a 10 to 15 percent chance that the transplanted pancreas would fail during the first year. When this happened, the long-term survival rate dropped to 74 percent.
Patients with Type 1 diabetes and advanced kidney disease face a difficult decision, according to Wiseman: “Should they try to get on the waiting list for SPK and assume the greater surgical risk, or should they accept a kidney from a living donor and live with continued diabetes? If they opt for kidney transplant alone, they then must decide whether to undergo a separate pancreas transplant later on.” In Wiseman’s study, even this option did not lead to better survival than successful SPK transplantation.
The new findings help to guide this decision by comparing the benefits and risks of the various transplant options. “Overall, the chances for better long-term success favor the SPK option, particularly if the waiting time for an SPK is not long—this varies with regions of the United States,” Wiseman said.
The study is posted on line at http://cjasn.asnjournals.org/
The University of Colorado Denver School of Medicine faculty work to advance science and improve care. These faculty members include physicians, educators and scientists at University of Colorado Hospital, The Children’s Hospital, Denver Health, National Jewish Health, and the Denver Veterans Affairs Medical Center. Degrees offered by the CU Denver School of Medicine include doctor of medicine, doctor of physical therapy, and masters of physician assistant studies. The School is part of the University of Colorado Denver, one of three campuses in the University of Colorado system. For additional news and information, please visit the CU Denver newsroom online.