Optimal timing for a pancreas transplant after a successful kidney transplant

Background. For certain uremic, diabetic patients, a sequential transplant of a kidney (usually from a living donor) followed by a cadaver pancreas ha s become an attractive option. But how long to wait after the kidney transp lant before proceeding with a pancreas transplant is unclear, We studied ou tcomes in recipients of a pancreas at varying times after a kidney to deter mine the optimal timing for the second transplant. Methods. We compared pancreas after kidney (PAK) transplants performed earl y (less than or equal to4 months) and late (>4 months) after the kidney tra nsplant to determine any significant differences in surgical complications or outcomes between the two groups, Results. Between January 1, 1994, and September 30, 1998, we performed 123 cadaver PAK transplants, Of these, 25 (20%) were early and 98 (80%) were la te. Characteristics of the two recipient groups were similar. We found no s ignificant differences in outcome between the two groups, The incidence of surgical complications (bleeding, leaks, thrombosis, infections) and of opp ortunistic infections (such as cytomegalovirus) did not significantly diffe r between the two groups, Graft and patient survival rates were also equiva lent (P=NS), The incidence of acute rejection by 3 months posttransplant wa s 20% in both groups, Conclusion. The timing of the pancreas transplant for PAK recipients does n ot seem to influence outcome. As long as an acceptable organ is available a nd the recipient is clinically stable, a PAK transplant can be performed re latively soon after the kidney transplant.