OUTCOMES IN DIABETIC-PATIENTS AFTER SIMULTANEOUS PANCREAS-KIDNEY VERSUS KIDNEY ALONE TRANSPLANTATION

Background. Previous studies have identified more morbidity in simulta neous pancreas-kidney (SPR) transplant recipients compared with kidney alone (KA) recipients, With the development of novel immunosuppressiv e drugs, studies are needed to determine optimal treatment regimens in specific patient populations, Methods, We retrospectively compared sh ort-term outcome in diabetic patients receiving either SPK or KA trans plantation from December 10, 1991, to July 31, 1996., The SPK recipien ts received either cyclosporine (CsA) + azathioprine (AZA), FK506+AZA, or FK506 + mycophenolate mofetil (MM). KA group patients received eit her CsA+AZA or CsA+MM. Results, Recipients of SPK instead of KA transp lants were younger, had a longer mean length of stay, had a decreased incidence of delayed graft function, and had more readmissions. There were no significant differences in serum creatinine at 1, 2, and 3 yea rs after transplantation, number of rejection episodes and infections, incidence of kidney graft loss and patient death, and 1- and 3-year a ctuarial patient and kidney graft survival rates between the two group s, Diabetic SPK patients receiving FK506+MM had a higher mean S-month creatinine clearance (calculated), compared with recipients of CsA+AZA or FK506+AZA. Diabetic patients after KA transplantation who received CsA+MM demonstrated fewer rejection episodes and graft losses, althou gh differences did not reach statistical significance, Conclusions, (1 ) Diabetic SPK recipients have decreased rates of delayed graft functi on and more readmissions compared with diabetic KA recipients, (2) The re is no difference in: serum creatinine levels up to 3 years after tr ansplantation, number of rejection episodes or infections, and 1- and 3-year patient and graft survival rates between SPK and KA recipients, (3) Short-term outcome is improved in diabetic recipients of SPK and RA transplants receiving MM instead of AZA.