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Transplant Proc. 2018 Dec;50(10):3249-3254. doi: 10.1016/j.transproceed.2018.06.014. Epub 2018 Jun 22.

Effectiveness of Preceding Solo Kidney Transplantation for Type 1 Diabetes With End-Stage Renal Failure.

Author information

1
Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Aichi, Japan.
2
Registry of Japanese Pancreas Transplantation, Japan Society for Pancreas & Islet Transplantation, Osaka, Japan. Electronic address: i-taihei@fujita-hu.ac.jp.

Abstract

Preceding solo kidney transplantation for type 1 diabetes with end-stage renal failure is controversial because of less pancreatic graft survival in pancreas transplantation after kidney transplantation (PAK) than in simultaneous pancreas and kidney transplantation (SPK).

METHODS:

To study the effectiveness of preceding solo kidney transplantation for type 1 diabetes with end-stage renal failure, comparative retrospective analysis was performed between SPK (n = 232) and PAK (n = 39) that were performed until December 2016.

RESULTS:

At 1, 3, and 5 years, pancreatic graft survival in SPK was 87.5%, 86.4%, and 82.8%, respectively, and 87.1%, 65.0%, and 49.1%, respectively, in PAK, which showed lesser long-term graft survival than SPK. Because 10 cases out of 16 (62.5%) failed into pancreatic graft loss with rejection in PAK, which was about 3 times more than in SPK, control of rejection is very important; rejection episodes were decreased by rabbit antithymocyte globulin induction resulting in improved graft survival. Five-year patient survival was 88.0% in SPK and 96.6% in PAK.

CONCLUSION:

Considering patient survival, preceding solo kidney transplantation for type 1 diabetes with end-stage renal failure should be performed if a donor is available.

[Indexed for MEDLINE]

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