Simultaneous Pancreas-Kidney Transplantation Versus Living Donor Kidney Transplantation Alone: an Outcome-Driven Choice?

Current Diabetes Reports
Vishnu Swaroop Venkatanarasimhamoorthy, Adam D Barlow

Abstract

The choice of optimum transplant in a patient with type 1 diabetes mellitus (T1DM) and chronic kidney disease stage V (CKD V) is not clear. The purpose of this review was to investigate this in more detail-in particular the choice between a simultaneous pancreas-kidney transplantation (SPKT) and living donor kidney transplantation (LDKT), including recent evidence, to aid clinicians and their patients in making an informed choice in their care. Analyses of large databases have recently shown SPKT to have better survival rates than a LDKT in the long-term, despite an early increase in morbidity and mortality in SPKT recipients. This survival advantage has only been shown in those SPKT recipients with a functioning pancreas and not those who had early pancreas graft loss. The choice of SPKT or LDKT should not be based on patient and graft survival outcomes alone. Individual patient circumstances, preferences, and comorbidities, among other factors should form an important part of the decision-making process. In general, an SPKT should be considered in those patients not on dialysis and LDKT in those nearing or already on dialysis.

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Citations

Jan 23, 2020·World Journal of Transplantation·Sanem Guler CimenAcar Tuzuner
Dec 17, 2020·Pharmacotherapy·Danielle KovacDouglas L Jennings
Apr 2, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·Sorina M CornateanuGabriel C Oniscu

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