Results after 13 years of kidney-pancreas transplantation in type 1 diabetic patients in Comunidad Valenciana

• Published in: Cirugia española (English ed.) 2021-11, Vol.99 (9), p.666-677
• Main Authors: Argente-Pla, María, Martínez-Millana, Antonio, Espí-Reig, Jordi, Maupoey-Ibáñez, Javier, Moya-Herráiz, Ángel, Beneyto-Castello, Isabel, López-Andújar, Rafael, Merino-Torres, Juan Francisco
• Format: Article
• Language: English
• Subjects: Adult; Diabetes mellitus tipo 1; Diabetes mellitus type 1; Diabetes Mellitus, Type 1 - surgery; Diabetic kidney disease; Enfermedad renal diabética; Female; Humans; Kidney; Kidney Transplantation; Male; Pancreas; Pancreas Transplantation; Retrospective Studies; Simultaneous pancreas kidney transplantation; Trasplante simultáneo de páncreas-riñón; Treatment Outcome
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2021.10.001

Simultaneous pancreas-kidney (SPK) transplant is a proven option of treatment for patients with type 1 diabetes mellitus and related end-stage renal disease, who are candidates for kidney transplantation. The results from the beginning of SPK transplant program in Comunidad Valenciana are presented. Descriptive, retrospective, and single-center study of the pancreas transplant performed at the Hospital Universitari i Politècnic La Fe, from September 2002 to December 2015. Clinical variables from donors and recipients, peri-operative variables, patient survival, and pancreatic graft survival were collected. Eighty-one patients with type 1 diabetes mellitus (48 males and 33 females, mean age 37.4 ± 5.7 years, mean BMI 24.1 ± 3.4 kg/m2, mean duration of diabetes 25.5 ± 6.5 years) received SPK transplantation. The overall patient survival at one, 3, and 5 years were 91.3%, 91.3% and 89.5%, respectively. However, patient survival in the periods 2002−2008 and 2009−2015 were 88.2% and 93.6% at one year, 88.2% and 93.7% at 3 years, and 85.3% and 93.7% at 5 years, respectively (P = 1). The overall pancreatic graft survival at one, 3, and 5 years were 75.2%, 69.1% and 63.2%, respectively. On the other hand, pancreatic graft survival in the periods 2002−2008 and 2009−2015 were 67.5% and 80.6% at one year, 64.7% and 71.8% at 3 years, and 58.8% and 65.3% at 5 years, respectively (P = .0109). Post-transplant complications were: graft rejection 8.6%, venous graft thrombosis 7.4%, graft pancreatitis 4.9%. In 13 years’ experience of SPK transplantation, patient and pancreatic graft survival and the rate of complications after pancreas transplantation were similar to those of other larger series. The medical-surgical team experience improves pancreatic graft survival without influencing patient survival. El trasplante simultáneo de páncreas-riñón (SPK, por simultaneous pancreas kidney) es una opción terapéutica válida en pacientes afectos de diabetes mellitus tipo 1 con enfermedad renal crónica terminal que son candidatos a trasplante renal. Se presentan los resultados desde el inicio del programa de trasplante SPK en la Comunidad Valenciana. Estudio descriptivo, retrospectivo y unicéntrico de los trasplantes de páncreas realizados en el Hospital Universitari i Politècnic La Fe, desde septiembre de 2002 a diciembre de 2015. Se recogieron variables clínicas de los donantes y receptores, variables peri-operatorias y supervivencia del paciente y del injerto pancreático. Ochent