Long-term follow-up of 78 simultaneous pancreas-kidney transplants at a single-center institution in Europe.
BACKGROUND
The objective of this study was to determine the long-term results after simultaneous pancreas-kidney transplantation (SPK) at a single-center institution in Europe.


METHODS
Seventy-eight consecutive patients with insulin-dependent diabetes mellitus and end-stage nephropathy were followed for a median of 7 years after SPK. Immunosuppressive protocol consisted of cyclosporine A, azathioprine, prednisone, and antithymocyte globulin. Multivariate Cox proportional hazard model was used to investigate the impact of different putative risk factors on long-term patient survival. Health-related quality of life was assessed by a validated questionnaire (SF-36).


RESULTS
Patient survival at 5 and 10 years was 81% and 67%, respectively. Pancreas function rate was 73% and 60% and kidney function 67% and 44%, respectively. In multivariate analysis, preexisting myocardial infarction (relative risk [RR] 5.1, 95% confidence interval [CI] 1.5-16.6) and amputation (RR 3.7, 95% CI 1.1-12.9) were strongly associated with a diminished long-term patient survival. Analysis of patients with long-term functioning pancreas and kidney grafts revealed excellent results for quality of life posttransplant that were comparable with average scores of the normal German population.


CONCLUSIONS
This series representing the largest experience with long-term follow-up in Europe confirms an excellent long-term survival and an exceptional quality of life after SPK.
Drognitz
Oliver
O
University of Freiburg, Department of General and Visceral Surgery, Freiburg, Germany. oliverdrognitz@web.de
Benz
Stefan
S
Pfeffer
Frank
F
Fischer
Christoph
C
Makowiec
Frank
F
Schareck
Wolfgang
W
Hopt
Ulrich Theodor
UT
D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007239:Infections / Q000209:etiology / Q000401:mortality; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation / Q000401:mortality; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology; D010179:Pancreas / Q000503:physiopathology; D016035:Pancreas Transplantation / Q000401:mortality; D011183:Postoperative Complications; D011788:Quality of Life; D016019:Survival Analysis