Successful long-term kidney-pancreas transplants regardless of C-peptide status or race

Background. me have previously shown that our patient population of 60% min ority races has end-stage renal disease primarily as a result of diabetes m ellitus and hypertension. Pt therefore was logical to explore the restorati on of normal insulin production and renal function by simultaneous pancreas -kidney (SPK) transplantation, without regard to race. This study represent s new analyses integrating race with C-peptide status and reports the outco me of 136 SPK transplantations performed over the last 10 years. Results. Of the 49 African-Americans with diabetes mellitus and end-stage r enal disease, 60% were type I and 40% were type II, based on C-peptide leve ls. In comparison, only 16% of Caucasians were type EP, The average age at onset of diabetes mellitus was 15.7 years for type I compared with 20.7 yea rs for type II (P>0.05). The actuarial 10-year survival rates for the 136 S PKs were 91.79% (patient), 85.07% (pancreas), and 83.58% (kidney). The type I and type II survival rates were similar in the two diabetic groups. Conclusions. The data strongly suggest that pretransplant C-peptide status does not influence the outcome of SPK transplantation in patients with rena l failure from diabetes mellitus. SPK transplants should be offered to all suitable diabetic patients with renal failure regardless of C-peptide statu s or race.