In diabetic patients with end stage renal disease who has a potential living kidney donor, pancreas after living kidney transplantation (PAK) or simultaneous cadaveric pancreas and living kidney transplantation (SPLK) is a treatment option. Considering the different setting of treatment modality, it is needed to analyze the outcome of both pancreas and kidney graft in both groups. We attempted to scrutinize the results of both procedure in our 2 year follow-up study as a single center analysis.
Among the total 154 pancreas transplantation performed between January 2004 and December 2012, 30 patients were analyzed grouping 17 SPLK and 13 PAK.
The patients in SPLK were 11 males and 6 females with a mean age of 37.2+6.6 years, while In PAK, 5 males and 8 females with a mean age of 44.6+9.3 years. Waiting time for pancreas transplantation differed significantly between SPLK and PAK: 385 days in SPLK and 619 days in PAK. 2 year pancreas, kidney, and patient survival rates were 100% each in both SPLK and PAK recipients. Pancreas rejection free survival rates in SPLK and PAK were 100% and 91.7% each, Kidney rejection free survival rates in SPLK and PAK were 87.4% and 100% respectively. Regarding the renal graft function measured by serum creatinine level, that of SPLK seems to be better than PAK during the early post operative period. At 1 month after transplantation, the mean creatinine level was 1.2 mg/dl in SPLK and 1.8mg/dl in PAK (P=0.007). However renal function in PAK group recovered at post operation 3 months as 1.4 mg/dl vs. 1.5mg/dl and finally showed the compatible results with the SPLK.
As a treatment modality of pancreas transplantation, SPLK has an advantage over the PAK by shortening the waiting time. Elevated creatinine at the early post operative period in PAK might be due to high level of CNI drug, but it was recovered over the time. Considering the compatible graft survival and rejection rate, either treatment can be done without so much of difference except waiting time.
To cite this abstract in AMA style:Jung J, Kim Y, Han Y, Chung Y, Cho H, Park J, Han D. Treatment Option in Diabetic End Stage Renal Disease Patients with Potential Living Kidney Donor: PAK vs. SPLK [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/treatment-option-in-diabetic-end-stage-renal-disease-patients-with-potential-living-kidney-donor-pak-vs-splk/. Accessed January 17, 2018.
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