Combo Kidney-Pancreas Transplant Boosts Survival in Diabetics

[okarol]

Combo Kidney-Pancreas Transplant Boosts Survival in Diabetics

Wed May 21, 7:02 PM ET

WEDNESDAY, May 21 (HealthDay News) -- Compared to kidney transplantation alone, a simultaneous kidney-pancreas transplant improves the likelihood of long-term survival in patients with type 1 diabetes and end-stage renal disease (ESRD), according to a German study.

The researchers analyzed the long-term outcomes of more than 11,000 patients with type 1 diabetes and ESRD who had a kidney transplant between 1984 and 2000, including 3,500 who had simultaneous kidney-pancreas transplantation. In some cases, patient and transplanted kidney survival were evaluated up to 18 years after the transplant.

After adjusting for other factors, the researchers concluded that patients who received simultaneous kidney-pancreas transplants had better long-term survival. Beyond 10 years, the risk of death in the kidney-pancreas group was 45 percent lower than in the kidney group.

That improved long-term survival was largely the result of a lower risk of cardiovascular disease -- 37 percent among kidney-pancreas patients compared with 46 percent to 49 percent in kidney-only patients.

"Based on these results, we feel that all type 1 diabetics with kidney failure should be considered for simultaneous pancreas-kidney transplantation," Dr. Christian Morath, of the University of Heidelberg, said in a prepared statement.

The study appears in the August issue of the Journal of the American Society of Nephrology.

"Our study shows that a functioning pancreas has a benefit for the simultaneously transplanted kidney," Morath said. "At the same time, this procedure prolongs the survival of the patient, compared to a patient who received only a kidney transplant."

Morath said the lower risk of cardiovascular death among kidney-pancreas transplant patients "is most likely due to the [normal blood sugar levels] in patients who received a combined treatment."

The results "show an interaction of different and independent organs -- kidney, pancreas, and heart -- with respect to survival of the patient."

More information

The National Kidney Foundation has more about kidney transplantation.

http://news.yahoo.com/s/hsn/20080521/hl_hsn/combokidneypancreastransplantboostssurvivalindiabetics

[stauffenberg]

This result is paradoxical, however.  A large-scale epidemiological study of the development of complications in type 1 diabetics from the early 1950s to the present has found that with increasing improvement in blood sugar control (as a result of new medical theories and new testing devices developed over that period), some complications have declined in incidenc but others have not.  Kidney disease and heart disease were two of the complications which did not improve over the generations with improved control of blood sugar.  The theory is that these complications may be caused by genes inherited along with the genetic predisposition to develop type 1 diabetes in the presence of some unknown stress factor, but that they are not due to high blood sugar per se.

[Chris]

I can attest to the story. If I had just had the kidney transplant, I still would have had trouble with not knowing I hypoglycemia, which in part led frequent trips to the hospital. With the simultaneous tx, I fel a lot better and still alive a kicking, which may not have happened if I stayed on dialysis or just had a plain kidney tx.