title: Simultaneous pancreas kidney transplants in diabetic patients with end-stage renal disease: the 20-yr experience.
abstract: BACKGROUND
  We are reporting the results over a 20 yr period of simultaneous pancreas-kidney transplants in patients with end-stage renal disease and diabetes mellitus. The outcomes of the transplants, performed between 1989 and 2008, are stratified by pretransplant c-peptide value.
  
  
  METHODS
  One hundred and seventy-three patients with end-stage renal disease due to diabetes, and were stratified according to undetectable c-peptide (x < 0.8 ng/mL) and detectable c-peptide (x > 0.8 ng/mL) levels.
  
  
  RESULTS
  Patients with detectable c-peptide (x > 0.8 ng/mL) were the oldest at diabetes diagnosis (24.2 vs. 15.4 yr, p < 0.0001), and oldest at transplant (42.8 vs. 38.5, p < 0.0001) had fewer years of insulin use (19.19 vs. 22.57 yr, p = 0.012), and were heavier pre transplant (BMI: 26.09 vs. 23.1, p < 0.0001), and heavier post transplant (29.8 vs. 24.7, p < 0.0001). Those with detectable c-peptide levels (x > 0.8 ng/mL) had better graft survival than those with an undetectable c-peptide level (x < 0.8 ng/mL), p = 0.064; while those with undetectable levels, had better patient survival than those with detectable c-peptide levels (p = 0.019).
  
  
  CONCLUSIONS
  Despite the differences between groups by BMI, age of onset of insulin use, and age at transplant, there was a difference in patient but not graft survival within the 20 yr follow-up period.
authors.affiliation: Division of Transplantation, Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Light
authors.forename: Marvin
authors.initials: M
authors.lastname: Tucker
mesh_terms: D002096:C-Peptide / Q000378:metabolism; D048909:Diabetes Complications / Q000401:mortality* / Q000601:surgery; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality* / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D002096:C-Peptide