Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Although both pancreas transplantation alone (PTA) and islet cell transplantation (ICT) have been associated with peri-operative declines in eGFR, the magnitude of decline is far less than that associated with medically managed (MM) diabetes. In the long-term, PTA and ICT have demonstrated stabilization of chronic kidney disease (CKD) for type 1 diabetic patients. In this setting, it remains unclear whether PTA/ICT transplantation reduces future need for kidney transplantation and mortality.
*Methods: A decision analytic Markov state transition model was created to simulate the life of type 1 diabetic patients with CKD who underwent one of three interventions: 1) PTA, 2) ICT, or 3) MM. Estimated declines in eGFR, chance of requiring kidney transplant, and mortality were calculated following each intervention for a simulated cohort of 3,000 patients. Base case patients were defined as 30 year old type 1 diabetic patients with an initial eGFR of 30 ml/min/1.732. Sensitivity analysis of initial eGFR was performed. Markov model parameters were extracted from literature review.
*Results: PTA and ICT was associated with improved long-term survival across a spectrum of initial eGRF (15-60 ml/min/1.732). For base case patients, ICT patients required fewer transplants, and gained 17.8 years of life compared to MM patients, and 3.8 years of life compared to PTA patients.
*Conclusions: ICT is associated with stabilization of eGFR, thereby reducing need to future kidney transplantation and improving long-term survival.
To cite this abstract in AMA style:Choudhury RA, Yoeli D, Moore HB, Yaffe H, Conzen KD, Nydam TL, Kennealey PT. Pancreas Transplant in Chronic Kidney Disease for Type 1 Diabetic Patients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/pancreas-transplant-in-chronic-kidney-disease-for-type-1-diabetic-patients/. Accessed May 18, 2021.
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