After a decade of experience with simultaneous kidney-pancreas
transplant, the transplant community has witnessed continued improvement in the
survival of patients and the grafts themselves.
The following experiences have recently been reported in the literature:
- Investigators at the University of Wisconsin School of Medicine reported
that the 1- and 5-year patient survival rates for a series of 381
kidney-pancreas transplants were 96% and 88% respectively. The 1- and 5-year
survival rates were 87% and 78% for kidney allografts and 86% and 74% for
pancreas allografts, respectively. (Exp Clin Endocrinol Diabetes
1996;104:353-359)
- In an analysis of the effect of race on outcome after kidney-pancreas
transplantation in type 1 diabetic patients, researchers at the Medical
University of South Carolina found that, compared with whites, there may be a
trend toward an improved kidney and pancreas graft outcome in blacks. The
survival of kidney grafts at 1, 2, and 5 years was 95%, 92%, and 74% in blacks
and 83%, 77%, and 58% in whites, respectively. While pancreas graft survival
remained at 81% at 1, 2, and 5 years of follow-up in blacks, the rates
decreased from 81%, to 75%, and finally to 62% in whites over the same time.
(Diabetes Care 1997;20:1310-1314)
- French researchers found that survival with combined kidney-pancreas
transplantation is similar to survival with renal transplant alone in patients
younger than 45 who are free of severe cardiovascular disease. They reported
that although combining a pancreas graft and kidney graft inevitably increases
postoperative morbidity, "many young patients are very willing to pay the
price in order to benefit from a combined graft." (Presse Med
1997;26:905-907)
- In a University of Washington study of the impact of hepatitis C virus
(HCV) infection on kidney-pancreas recipients, patients with HCV had a 3.7
times higher risk of death after transplant and were 3.4 times more likely to
develop kidney graft failure than patients without HCV. The risk of pancreas
allograft failure was similar in both groups. (Transplantation
1997;64:281-286)
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