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.