Solitary pancreas transplantation for diabetes mellitus remains a controversial procedure.
In this study, researchers evaluated the association between solitary pancreas transplantation and survival in patients with diabetes and preserved kidney function.
|Relative risk of mortality was 1.57 for pancreas transplant alone.|
|Journal of the American Medical Association|
The team performed a retrospective observational cohort study. They assessed 11,572 patients with diabetes mellitus on the waiting list for pancreas transplantation, between 1995 and 2000.
All patients receiving a multiorgan transplant were excluded. Patients who had a serum creatinine level greater than 2 mg/dL at time of listing were also excluded.
The team measured all-cause mortality in the 4 years following transplantation. This was compared with mortality in patients who remained on the waiting list.
They found that the relative risk of mortality was 1.57 for pancreas transplant alone, 1.42 for pancreas-after-kidney transplant, and 0.43 for simultaneous pancreas-kidney transplant.
Transplant patient 1- and 4-year survival rates were 97% and 85% for pancreas transplant alone, and 9% and 85% for pancreas-after-kidney transplant.
In comparison, the 1- and 4-year survival rates for patients on the waiting list were 98% and 92% for pancreas transplant alone and 97% and 88% for pancreas-after-kidney transplant.
Dr Jeffrey Venstrom's team concluded, "Survival…was significantly worse compared with the survival of waiting-list patients receiving conventional therapy".