Combo Kidney-Pancreas Transplant Boosts Survival in Diabetics

Type 1 patients did better than those having kidney replacement alone

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WEDNESDAY, May 21 (HealthDay News) -- Compared to kidney transplantation alone, a simultaneous kidney-pancreas transplant improves the likelihood of long-term survival in patients with type 1 diabetes and end-stage renal disease (ESRD), according to a German study.

The researchers analyzed the long-term outcomes of more than 11,000 patients with type 1 diabetes and ESRD who had a kidney transplant between 1984 and 2000, including 3,500 who had simultaneous kidney-pancreas transplantation. In some cases, patient and transplanted kidney survival were evaluated up to 18 years after the transplant.

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After adjusting for other factors, the researchers concluded that patients who received simultaneous kidney-pancreas transplants had better long-term survival. Beyond 10 years, the risk of death in the kidney-pancreas group was 45 percent lower than in the kidney group.

That improved long-term survival was largely the result of a lower risk of cardiovascular disease -- 37 percent among kidney-pancreas patients compared with 46 percent to 49 percent in kidney-only patients.

"Based on these results, we feel that all type 1 diabetics with kidney failure should be considered for simultaneous pancreas-kidney transplantation," Dr. Christian Morath, of the University of Heidelberg, said in a prepared statement.

The study appears in the August issue of the Journal of the American Society of Nephrology.

"Our study shows that a functioning pancreas has a benefit for the simultaneously transplanted kidney," Morath said. "At the same time, this procedure prolongs the survival of the patient, compared to a patient who received only a kidney transplant."

Morath said the lower risk of cardiovascular death among kidney-pancreas transplant patients "is most likely due to the [normal blood sugar levels] in patients who received a combined treatment."

The results "show an interaction of different and independent organs -- kidney, pancreas, and heart -- with respect to survival of the patient."

More information

The National Kidney Foundation has more about kidney transplantation.

-- Robert Preidt