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Your Online Resource for Diabetes Treatment
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Patient and Graft Survival in Diabetic Subjects Receiving LRD or SPK Transplants
Diabetic patients who require and who have can be maintained with and dialysis, with a 5-year survival of 21%. Alternatively, they can receive a transplant and be maintained with insulin, with a 5-year survival approaching 70% with a cadaveric kidney or 85% with a kidney from a living relative. Patients can also receive a simultaneous pancreas-kidney (SPK) transplantation and not require exogenous insulin, with a 5-year survival rate approaching 85%. A retrospective study utilizing data from the University of Wisconsin Medical School was undertaken to determine whether living related donor (LRD) transplants or SPK transplants are better for diabetic patients with ESRD.
Data were examined from all diabetic patients receiving LRD (n=130; 43 HLA-identical and 87 haplotype-identical) or cadaveric (n=296) transplants or SPKs (n=379) from January 1986 through January 1996. Patient survival was found to be similar for the LRD and SPK groups but significantly lower for the cadaveric transplant group. Five-year survivals for the HLA-identical, haplotype-identical, SPK, and cadaveric transplant groups were 94%, 85%, 88%, and 72%, respectively. Five-year graft survivals were similar in the LRD and SPK groups but significantly lower in the cadaveric transplant group. The authors of the study indicated that patient and donor selection efforts may have contributed to the poorer survival rates in recipients of cadaveric kidneys, because patients who received cadaveric kidneys were 10 years older than recipients of the other types of transplants. Furthermore, the acceptance criteria for the cadaveric kidneys were less stringent.
Thus, there was no difference in patient or graft survival in diabetic patients receiving LRD or SPK transplants. Graft and patient survival rates were lower in recipients of cadaveric transplants than in recipients of the other types of transplants.
Rayhill SC, D'Alessandro AM, Odorico JS, et al. Simultaneous pancreas-kidney transplantation and living related donor transplantation in patients with diabetes: Is there a difference in survival? Ann Surg. 2000;231:417-423.
The above summary is adapted from the cited reference.
Rayhill SC, D. Patient and Graft Survival in Diabetic Subjects Receiving LRD or SPK Transplants. Ann Surg.. 2000;231:417-423.
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