Introduction

Simultaneous pancreas and kidney transplantation (SPK) offers a survival advantage to diabetic kidney patients over deceased donor renal transplantation alone. Whereas outcomes for SPK transplantation are generally reported from the time of transplant, it is likely that patient survival will also depend upon events that occur while waiting for transplantation.

Methods

We retrospectively compared outcomes for consecutive patients listed for either kidney only or SPK transplantation over a four-year time period. Patients were categorised into three groups: group 1 remained active on the waiting list until transplantation without suspension; group 2 were suspended on at least one occasion and were yet to receive a transplant and group 3 comprised patients who had been transplanted following suspension.

Results

Of the 540 patients included in the study, no difference was found in the median time to transplantation between the kidney only and SPK patient cohorts (255 days vs 248 days, p = 0.0674), with similar proportions of patients composing groups 1, 2 and 3. SPK patients were more likely to have at least one episode of suspension from the waiting list (59% vs 48% for kidneys alone, p = 0.046) with a shorter time to first suspension episode compared to those listed for kidneys alone (57 days vs 119 days, p = 0.016). Significant differences were also found in the time from waitlisting to transplantation between groups 1 and 3 in both SPK (162 days vs 352 days, p <0.001) and kidney cohorts (184 days vs 453 days, p <0.001), however rates of transplantation despite suspension remained equivalent between the two groups (56% SPK vs 48% kidneys, p=0.273).

Conclusion

In comparison to kidney only patients, more patients listed for SPK transplantation are suspended prior to receiving a transplant, resulting in increased waiting time. These results suggest that although there may a narrow window for transplantation prior to suspension for patients awaiting an SPK, this does not prohibit patients from successfully receiving a transplant in future.

CITATION INFORMATION: Surendrakumar V., Richards J., Hossain M., Pettigrew G. Waiting List Outcomes for Patients Registered for Simultaneous Pancreas and Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).

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