Kidney Graft and Patient Survival With and Without a Simultaneous Pancreas Utilizing Contralateral Kidneys From the Same Donor
- Kayo Waki, MD, PHD and
- Paul I. Terasaki, PHD
- Terasaki Foundation Laboratory, Los Angeles, California
- Address correspondence and reprint requests to Kayo Waki, MD, MPH, PhD, Terasaki Foundation Laboratory, 11570 Olympic Blvd., Los Angeles, CA 90064. E-mail: kwaki{at}terasakilab.org
- KA, kidney-alone transplantation
- SPK, simultaneous pancreas-kidney transplantation
- UNOS, United Network for Organ Sharing
Simultaneous pancreas-kidney transplantation (SPK) is considered the treatment of choice for type 1 diabetic patients with end-stage renal disease. The American Diabetes Association supports pancreas transplantation for diabetic patients who have had, or plan to have, a kidney transplant (1). When the procedure is successful, a majority of pancreas transplant recipients have normal levels of glycemia and normal to nearly normal levels of HbA1c (2,3), improving their quality of life (3,4). However, whether pancreas transplants independently contribute to the survival benefit following an SPK above that achieved by a kidney-alone transplantation (KA) is inconclusive (5–9). We analyzed those patients who received SPK or KA using contralateral kidneys from the same deceased donors, who were ideal paired control patients for donor variables.
RESEARCH DESIGN AND METHODS
We analyzed data from all approved U.S. transplant programs collected by the United Network for Organ Sharing (UNOS). Eligible patients were those who received their first SPK or KA from January 1995 to December 2002. In the 544 type 1 diabetic patient pairs, one of the patients received a KA and the other patient received an SPK from the same deceased donors. Our analysis included follow-up information received through December 2004.
Patient characteristics were compared using the paired t test for continuous variables and the McNemar’s test for …
