Introduction: Insulin-dependent diabetes mellitus (DM) is a debilitating disease resulting in life-limiting secondary complications. A successful pancreas (Pa) transplant (Tx) achieves normoglycemia, extends life expectancy and improves quality of life. An additional post-tx objective is for the recipient to return to work or find employment. The study purpose was to look into employment patterns after Tx.

Methods: This study analyzed 4,476 adult primary deceased donor Pa Txs for DM T1 &2 as reported to UNOS from 1/2010 to 12/2014. The majority of Txs were SPK (82%], followed by Pa after Kd Txs (PAK, 10%) and Pa Txs Alone (PTA, 8%). The work status at the time of Tx and 1-yr post-tx were analyzed. Comprehensive methods were applied to identify potential factors influencing the status before and 1-yr after Tx. One-yr patient, pancreas (and kidney) graft survival for SPK was 97.6%, 90.0%, (95.8%); for PAK, 98%, 85.5%; for PTA, 97%, 83.7%.

Results: At time of TX, 34% of all patients worked for income; in 6%, the work status was unknown. The rate of patients working for income was significantly higher in solitary Txs (PAK 42%, PTA 51%) than in SPKs (31%) (p<0.0001). Patients not on dialysis were twice as likely to work for income (56%) than those on dialysis (26%). There was no difference in gender. Significantly more patients with DM T1 (35%) compared to DM T2 (24%) worked for income (p<0.0001). DM T1 &2 patients who worked for income were older and had a longer duration of their disease. This correlates with the functional status at time of Tx: dialysis impacts the functional status significantly (p<0.0001).

1-yr after successful Tx, 28% of recipients reported to be working for income; in 24%, the work status was unknown. The rate of patients working for income was again significantly higher in solitary Txs (PAK 35%, PTA 38%) than in SPKs (26%) (p<0.0001). 65% of recipients continued to work after Tx, 14% stopped working. Of those patients who did not work before, 8% worked at 1-yr post-tx.

Summary: This analysis shows the impact of Pa Txs on employment patterns: (1) Before Tx, the loss of Kd function was also associated with loss in employment; if Kd function was preserved (PAK, PTA), an additional 1/3 of all patients worked; (2) After Tx, the rate of patients working was significantly higher in solitary Pa Txs than in SPKs. This demonstrates the advantage in employment if an early solitary Pa Tx is performed and before kidney function is lost.

CITATION INFORMATION: Gruessner S. Posttransplant Employment Patterns Are More Favorable in Patients with Solitary Pancreas vs. Simultaneous Pancreas/Kidney (SPK) Transplants – The Impact of Native Kidney Function. Am J Transplant. 2017;17 (suppl 3).

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