Survival Benefit of Preemptive Simultaneous Pancreas Kidney Transplantation

E. Montagud-Marrahi¹, E. Cuadrado-Payán¹, E. Hermida¹, D. Cucchiari¹, I. Revuelta¹, J. Del Risco-Zevallos¹, J. Casals¹, N. Esforzado¹, F. Cofan¹, F. Oppenheimer¹, V. Torregrosa¹, J. Ferrer², A. J. Amor³, E. Esmatjes¹, M. Ramirez-Bajo⁴, M. Musquera⁵, B. Bayés¹, J. Campistol¹, F. Diekmann¹, P. Ventura-Aguiar¹

¹Nephrology and Kidney Transplantation Department, Hospital Clínic of Barcelona, Barcelona, Spain, ²Hepatobiliopancreatic and Liver Transplant Department, Hospital Clínic of Barcelona, Barcelona, Spain, ³Diabetes Unit. Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, Barcelona, Spain, ⁴Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Fundació Clínic per a la Recerca, Hospital Clínic of Barcelona, Barcelona, Spain, ⁵Urology Department, Hospital Clínic of Barcelona, Barcelona, Spain

Meeting: 2022 American Transplant Congress

Abstract number: 433

Keywords: Kidney transplantation, Kidney/pancreas transplantation, Survival

Topic: Clinical Science » Pancreas » 65 - Pancreas and Islet: All Topics

Session Information

Session Name: Pancreas and Islet: All Topics

Session Type: Rapid Fire Oral Abstract

Date: Tuesday, June 7, 2022

Session Time: 3:30pm-5:00pm

Presentation Time: 4:30pm-4:40pm

Location: Hynes Room 210

*Purpose: Diabetes mellitus is a well-established risk factor for morbidity and mortality among patients on dialysis, but the evidence regarding the benefits of performing preemptive SPK (pSPK) is controversial. Thus, the aim of the study was to explore the survival advantage of performing a pSPK compared with non-preemptive SPK (npSPK) and preemptive Kidney Transplant Alone (pKTA) recipients.

*Methods: To explore the survival advantage of performing a pSPK we compared the outcomes in pSPK with npSPK recipients between 2000 and 2017 from the OPTN/UNOS registry. To account for the potential benefit provided solely by the kidney transplant, we further compared to recipients of pKTA with diabetes. A propensity score analysis was applied.

*Results: A total of 1522 patients received a pSPK, 7894 a npSPK, and 3343 a pKTA. Overall recipient survival was superior for the pSPK group when compared to the pKTA (97.7%, and 80.9% vs 97.7% and 72.9% at 1 and 10 years, respectively,P<0.001), with pKTA being associated with an increased risk of patient death (HR 1.34 [95%CI 1.10-1.63],P=0.003).Estimated kidney graft survival was similar in both groups. After IPTW adjustment, pKTA was significantly associated with an increased risk of death-censored kidney graft failure (HR 1.31 [95%CI 1.09-1.56],P=0.002). The npSPK patients presented both worse patient and kidney graft survival when compared to pSPK.

*Conclusions: In conclusion, the observed survival benefit of performing a SPK preemptively reinforces the need for early referral for transplantation in patients with insulin-dependent diabetes and advanced chronic kidney disease.

To cite this abstract in AMA style:

Montagud-Marrahi E, Cuadrado-Payán E, Hermida E, Cucchiari D, Revuelta I, Risco-Zevallos JDel, Casals J, Esforzado N, Cofan F, Oppenheimer F, Torregrosa V, Ferrer J, Amor AJ, Esmatjes E, Ramirez-Bajo M, Musquera M, Bayés B, Campistol J, Diekmann F, Ventura-Aguiar P. Survival Benefit of Preemptive Simultaneous Pancreas Kidney Transplantation [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/survival-benefit-of-preemptive-simultaneous-pancreas-kidney-transplantation/. Accessed November 21, 2024.

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