HDCN Article Review/Hyperlink

Douzdjian V, Rice JC, Gugliuzza KK, Fish JC, Carson RW

Renal allograft and patient outcome after transplantation: pancreas-kidney versus kidney-alone transplants in type I diabetics vs kidney-alone transplants in nondiabetics

Am J Kidney Dis (Jan) 27:106-116 1996

With advances in immunosuppression and technique, outcome of simultaneous pancreas-kidney (SPK) transplantation has improved over the last decade. However, there is still contoversy about this procedure, with relatively poor results reported from some conters (see Manske et al. . In this study from the University of Texas at Galveston, the fate of SPK (n=61) transplants done between 1988-1994 was compared to kidney alone-transplants in diabetic (KA-D) (n=63) and kidney alone-transplants in nondiabetic (KA-ND)(n=80) patients matched for donor age, gender, race, interval from donor admission to procurement, DR mismatch, and recipient gender. Patient survival was highest in the KA-ND group (86% at 5 yr), intermediate (78%) in the SPK group, and lowest (66%) in the KA-D group (allograft survival was also lower in the KA-D group). Acute rejection was most frequent in SPK patients, although this did not affect graft survival. The authors conclude that outcome after SPK is acceptable, although they admit that selection bias may have favored the SPK group. (David J. Leehey, M.D., Loyola University, Maywood, IL)