Background. It is uncertain whether pancreas transplants in type 1 diabetics requiring kidney transplantations improve overall patient health and survival. The aim of this study was to look at the impact of pancreas transplants on type 1 diabetics, who received simultaneous pancreas kidney (SPK) transplantation, using the Framingham Risk Score (FRS) for 10-year cardiovascular disease (CVD) risk.

Methods. Between 2004 and 2012, 51 type 1 diabetics received SPK transplants and 18 received solitary kidney (SK) transplants. The two groups were matched in terms of age and donor renal function. The FRS for 10-year CVD risk was calculated and compared between the two groups pre-operatively and one-year post-operatively. Individual risk factors were also compared to determine which factors conferred the most significant influences on cardiac risk reduction.

Results. SPK and SK transplant patients received renal grafts that were equivalent in function as indicated by the donor glomerular filtration rate (GFR) (124.8±65.6 vs 111.4±40.9 mL/min/1.73 m2, p>0.05). Using the FRS calculator, we determined that pre-operative risk score for SPK transplant group was 12.5±8.6% compared with 8.9±7.0% one-year post-operatively (p = 0.0007). There was no significant difference in SK transplant group when comparing the pre and post-operative CVD risks. One year post-operatively, SPK recipients had reduced their total number of antihypertensive medications (p = 0.0000008) and statins (p = 0.001). SPK transplantations also decreased the recipients’ triglyceride levels from 1.36±0.81 mmol/L to 0.99±0.37 mmol/L (p = 0.003). In contrast, SK recipients had no changes in the number of antihypertensive medications or statins, and no difference in triglyceride levels. Unsurprisingly, SPK recipients had significantly lower post-operative HbA1c levels compared to SK recipients (5.6±1.1 vs 7.3±1.6 %, p = 0.01). However, there were no significant differences between the two groups with regards to post-operative SBP, HDL or LDL.

Conclusion. Pancreas transplantation has a positive impact on patient health based on the analysis of FRS for 10-year CVD risk. According to FRS, SPK transplantation reduced the CVD risk from intermediate (10-20%) to low (<10%) risk range. Resulting impact of pancreas transplantation on cardiovascular complications continue to be studied.

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