title: Improved patient survival in recipients of simultaneous pancreas-kidney transplant compared with kidney transplant alone in patients with type 1 diabetes mellitus and end-stage renal disease.
abstract: BACKGROUND
  There are emerging data that simultaneous pancreas-kidney transplant (SPK) prolongs life compared with kidney transplant alone (KTA) in type 1 diabetics with end-stage renal disease. This study was a retrospective comparison of SPK with KTA in patients with type 1 diabetes.
  
  
  METHODS
  Between 1 January 1992 and 30 April 2002, 101 patients with type 1 diabetes were transplanted. Fifty-one of these patients received a KTA and 50 had a SPK. All patients underwent coronary angiography with surgical correction of any coronary artery disease before being listed. All patients who underwent SPK received quadruple immunosuppressive therapy consisting of antilymphocyte globulin, calcineurin inhibitor (tacrolimus or cyclosporin), azathioprine and steroids. Those who underwent KTA received calcineurin inhibitor (tacrolimus or cyclosporin), azathioprine and steroids.
  
  
  RESULTS
  Patient survival at 1, 3, 5 and 8 years was 96, 93, 89 and 77 per cent respectively after SPK, and 93, 75, 57 and 47 per cent respectively after KTA (P = 0.018 at 8 years).
  
  
  CONCLUSIONS
  The addition of pancreatic transplantation prolongs life in type 1 diabetic patients with renal failure compared with renal transplantation alone.
authors.affiliation: Department of Transplantation, Nephrology and Dialysis, Beaumont Hospital, Dublin, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Mohan
authors.forename: K
authors.initials: K
authors.lastname: Safi
authors.forename: D M
authors.initials: DM
authors.lastname: Little
authors.forename: J
authors.initials: J
authors.lastname: Donohoe
authors.forename: P
authors.initials: P
authors.lastname: Conlon
authors.forename: J J
authors.initials: JJ
authors.lastname: Walshe
authors.forename: P
authors.initials: P
authors.lastname: O'Kelly
authors.forename: C J
authors.initials: CJ
authors.lastname: Thompson
authors.forename: D P
authors.initials: DP
authors.lastname: Hickey
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000401:mortality / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome