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Combined pancreas--kidney transplantation in Nebraska
R J Stratta1, R J Taylor, B H Zorn
1Department of Surgery, University of Nebraska Medical Center, Omaha 68198-3280.
The Nebraska Medical Journal
|December 1, 1991
Summary
Combined pancreas-kidney transplants offer Type I diabetics with nephropathy a chance at normal blood sugar levels and insulin independence, with excellent graft survival rates.
Area of Science:
- Nephrology
- Endocrinology
- Transplantation Surgery
Background:
- Type I diabetes mellitus (TIDM) frequently leads to diabetic nephropathy.
- Kidney failure in TIDM patients often necessitates transplantation.
- Simultaneous pancreas and kidney transplantation (SPKT) is a viable option for select patients.
Purpose of the Study:
- To evaluate the outcomes of SPKT in Type I diabetic patients with nephropathy.
- To assess the impact of SPKT on glycemic control and graft survival.
Main Methods:
- Retrospective analysis of 38 Type I diabetic patients undergoing SPKT over 2 years.
- Patients received quadruple immunosuppression with OKT3 induction.
- Outcomes measured included glycemic control (hemoglobin A1c), serum creatinine, and graft survival.
Main Results:
- All patients achieved normoglycemia and insulin independence.
- Mean glycosylated hemoglobin was 5.2% +/- 1.1%; mean serum creatinine was 1.9 mg/dl +/- 0.5.
- Patient survival was 100%, kidney graft survival was 100%, and pancreas graft survival was 94.7% at a mean follow-up of 15 months.
Conclusions:
- SPKT is the preferred treatment for Type I diabetics with nephropathy.
- SPKT effectively restores euglycemia despite the need for immunosuppression.