TY - JOUR
T1 - One year outcomes of simultaneous pancreas and kidney transplantation: twelve years of the Scottish national service
AU - Hayward, Sam J L
AU - Jansen, Christine
AU - Traynor, Jamie
AU - Metcalfe, Wendy
AU - Oniscu, Gabriel
PY - 2015/11/17
Y1 - 2015/11/17
N2 - Background: We report outcomes of the assessment process (2002–2013),and patient and organ outcomes at one year post SPK (Simultaneous Pancreas and Kidney transplant) in Scotland. Methods: Patients referred for SPK since 2002 were identified from the unitdata base. Outcomes were determined from the Scottish Renal Registry (SRR)and transplant unit electronic patient records. Follow-up data were collected until 31 December 2014. Results: 339 Scottish residents were assessed for SPK (2002–2013). 199(58.7%) were listed for SPK, 75 (22.1%) for kidney transplant, 61 (18%) not listed for either, 4 on-going assessment. 6 patients decided they wanted kidney alone, otherwise the decision was made on clinical grounds.Patients listed for SPK were younger (mean age 39.4 years SD 8) than those listed for kidney (mean 44.4 years SD 8.5 [p < 0.001]). 108 (54%) SPK listed were male versus 45 (60%) of kidney alone.73 (37%) were listed for SPK pre-emptively, ie before starting any RRT. 14 (19%) referred for SPK but listedfor kidney were listed pre-emptively.In the follow-up period 161 (81.9%) of those listed had received an SPK transplant; 150 patients had at least 1 year follow-up post-transplant. 5 (3.4%) died, all within 45 days of surgery, causes of death: haemorrhage associated with surgery (1); infection (3); ischaemic heart disease (1).22 (15%) patients had a pancreatectomy in the first year, again all within 45 days, reasons: non-viable organ (1), thrombosis/ischaemia (10), haemorrhage (1), duodenal anastomotic breakdown (10).121 patients had a functioning pancreas transplant at 1 year, HbA1c was available for 118 (97.5%). 98 (83%) had normal HbA1c (≤41 mmol/mol); 115(97.5%) had HbA1c which would represent good diabetic control (≤48 mmol/mol) and 3 had worse HbA1c control but were not yet on insulin. Conclusions: Less than 60% of patients referred for SPK were listed, but once listed more than 80% received a SPK transplant. Post SPK one year patient survival was 97%. Survivors had 97% one year kidney survival and83% one year pancreas survival with good glycaemic control.
AB - Background: We report outcomes of the assessment process (2002–2013),and patient and organ outcomes at one year post SPK (Simultaneous Pancreas and Kidney transplant) in Scotland. Methods: Patients referred for SPK since 2002 were identified from the unitdata base. Outcomes were determined from the Scottish Renal Registry (SRR)and transplant unit electronic patient records. Follow-up data were collected until 31 December 2014. Results: 339 Scottish residents were assessed for SPK (2002–2013). 199(58.7%) were listed for SPK, 75 (22.1%) for kidney transplant, 61 (18%) not listed for either, 4 on-going assessment. 6 patients decided they wanted kidney alone, otherwise the decision was made on clinical grounds.Patients listed for SPK were younger (mean age 39.4 years SD 8) than those listed for kidney (mean 44.4 years SD 8.5 [p < 0.001]). 108 (54%) SPK listed were male versus 45 (60%) of kidney alone.73 (37%) were listed for SPK pre-emptively, ie before starting any RRT. 14 (19%) referred for SPK but listedfor kidney were listed pre-emptively.In the follow-up period 161 (81.9%) of those listed had received an SPK transplant; 150 patients had at least 1 year follow-up post-transplant. 5 (3.4%) died, all within 45 days of surgery, causes of death: haemorrhage associated with surgery (1); infection (3); ischaemic heart disease (1).22 (15%) patients had a pancreatectomy in the first year, again all within 45 days, reasons: non-viable organ (1), thrombosis/ischaemia (10), haemorrhage (1), duodenal anastomotic breakdown (10).121 patients had a functioning pancreas transplant at 1 year, HbA1c was available for 118 (97.5%). 98 (83%) had normal HbA1c (≤41 mmol/mol); 115(97.5%) had HbA1c which would represent good diabetic control (≤48 mmol/mol) and 3 had worse HbA1c control but were not yet on insulin. Conclusions: Less than 60% of patients referred for SPK were listed, but once listed more than 80% received a SPK transplant. Post SPK one year patient survival was 97%. Survivors had 97% one year kidney survival and83% one year pancreas survival with good glycaemic control.
M3 - Article (Academic Journal)
SN - 0934-0874
VL - 28
SP - 653
JO - Transplant International
JF - Transplant International
IS - S4
ER -