title: Outcomes of simultaneous pancreas-kidney transplantation in type 2 diabetic recipients.
abstract: OBJECTIVE
  Type 2 diabetic patients with end-stage renal disease may receive a simultaneous pancreas-kidney (SPK) transplant. However, outcomes are not well described. Risks for death and graft failure were examined in SPK type 2 diabetic recipients.
  
  
  METHODS
  Using the United Network for Organ Sharing database, outcomes of SPK transplants were compared between type 2 and type 1 diabetic recipients. All primary SPK adult recipients transplanted between 2000 and 2007 (n=6756) were stratified according to end-stage pancreas disease diagnosis (type 1: n=6141, type 2: n=582). Posttransplant complications and risks for death and kidney/pancreas graft failure were compared.
  
  
  RESULTS
  Of the 6756 SPK transplants, 8.6% were performed in recipients with a type 2 diabetes diagnosis. Rates of delayed kidney graft function and primary kidney nonfunction were higher in the type 2 diabetics. Five-year overall and death-censored kidney graft survival were inferior in type 2 diabetics. After adjustment for other risk factors, including recipient (age, race, body weight, dialysis time, and cardiovascular comorbidities), donor, and transplant immune characteristics, type 2 diabetes was not associated with increased risk for death or kidney or pancreas failure when compared with type 1 diabetic recipients.
  
  
  CONCLUSIONS
  After adjustment for other risk factors, SPK recipients with type 2 diabetes diagnosis were not at increased risk for death, kidney failure, or pancreas failure when compared with recipients with type 1 diabetes.
authors: Department of Medicine, David Geffen School of Medicine, University of California–Los Angeles, Los Angeles, California 90024, USA.
authors: Marcelo Santos
authors: MS
authors: Sampaio
authors: Hung-Tien
authors: HT
authors: Kuo
authors: Suphamai
authors: S
authors: Bunnapradist
mesh_terms: D000328:Adult; D015897:Comorbidity; D016208:Databases, Factual / Q000706:statistics & numerical data; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000601:surgery*; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality; D012307:Risk Factors