Kidney plus pancreas transplant best for diabetics

People with type 1 diabetes who need a kidney transplant fare better over the long term when they receive a pancreas transplant at the same time. The following study shows that a functioning pancreas has a benefit for the simultaneously transplanted kidney. At the same time, this procedure prolongs the survival of the patient, compared to a patient who received only a kidney transplant. The reason for the improved survival with simultaneous pancreas-and-kidney transplantation is not fully known, but does relate to the enhanced glucose control achieved with the combined procedure. Researchers in Germany studied 2190 patients given a living-donor kidney, 5705 deceased-donor kidney recipients, and 3525 patients undergoing simultaneous pancreas-and-kidney transplantation. Compared with the other groups, the deceased-donor kidney group had inferior survival rates, the report indicates, a finding that is consistent with prior research. Initially, the pancreas-and-kidney group had worse survival than did the living-donor kidney group, but the pancreas-and-kidney group's rate eventually caught up, and beyond 10 years survival was higher. In fact, after 10 years, the risk of dying for pancreas-and-kidney recipients was 45 percent lower than for living-donor kidney patients. Based on the above results, all type 1 diabetics with kidney failure should be considered for simultaneous pancreas-kidney transplantation. However, further research in the field is needed.

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