Long-term outcome of simultaneous kidney-pancreas transplantation - Analysis of 61 patients with more than 5 years follow-up

Background The long-term outcome of simultaneous kidney pancreas transplant recipients is not well established. Methods. We retrospectively reviewed all patients who underwent simultaneou s kidney-pancreas transplantation with bladder drainage at our center betwe en January 1989 and December 1991. A total of 57 patients (93%) were alive with functioning grafts 1 year after transplantation and were followed for a minimum of 5 years. These patients formed the study group. Results. Five-year actual patient, kidney and pancreas survival rates were 95%, 85%, and 88%, respectively. Fasting serum glucose fell from 198 mg/dL preoperatively to 94 mg/dL and remained stable thereafter. Glycohemoglobin levels decreased from 9.8% preoperatively to 4.8% 1 year after transplantat ion and remained normal thereafter. Kidney function remained good, with mea n serum creatinine of 2.0 and creatinine clearance of 56 ml/min throughout the follow-up period. Hospital admissions decreased significantly with incr easing time after transplantation from a mean of 1.2 admissions per patient in the 1st year to a mean of 0.2 admissions per patient 6 years after tran splantation. Of the readmissions, 42% were for <48 hr and the most common r easons for readmission were infection, surgery, and dehydration. Mean systo lic blood pressure decreased from 166 mm Hg before the transplant to 142 mm Hg 1 year after the transplant. Conclusion. Simultaneous kidney pancreas transplantation is a safe and effe ctive method to treat advanced diabetic nephropathy and is associated with stable metabolic function, decreased cholesterol, improved hypertension con trol, improved rehabilitation over time, and little morbidity or mortality after the 1st year.