title: Low rates of short- and long-term graft loss after kidney-pancreas transplant from a single center.
abstract: OBJECTIVE
  Since the 1980s, pancreas transplant has become the most effective treatment strategy to restore euglycemia in patients with type 1 diabetes mellitus. However, technical complications and BK virus nephropathy continue to be important causes of early and late graft loss. These and other complications lead to cited 1- and 3-year graft survival rates of 74% and 67% (pancreas) and 81% and 73% (kidney).
  
  
  OBJECTIVE
  To examine our center's outcomes with pancreas-kidney transplant and early BK virus screening and treatment.
  
  
  METHODS
  Prospective study from August 2004 to January 2012.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  Sixty-five patients with type 1 diabetes who underwent simultaneous kidney and pancreas, pancreas after kidney, or pancreas transplant alone at a single center.
  
  
  METHODS
  Pancreas transplant.
  
  
  METHODS
  Pancreas and kidney survival; patient survival; and kidney loss due to BK virus nephropathy.
  
  
  RESULTS
  Patient survival at 1, 3, and 5 years was 100%, 98.4%, and 98.4%, respectively. Of 2 early pancreatic allograft losses, 1 was due to thrombosis (1.6%). One- and 5-year pancreas graft survival rates were 95.4% and 92.3%; losses after more than 1 year were due to rejection. Kidney survival rates were 100% and 95.2% at 1 and 5 years; losses were due to nephropathy and noncompliance, with 1 death with function. BK virus incidence was 29.2%, with no graft losses due to BK infection.
  
  
  CONCLUSIONS
  While pancreas transplant can be complicated by early graft loss, our results suggest that excellent outcomes at 5 years can be achieved. Posttransplant BK virus screening and treatment are essential tools to long-term success.
authors.affiliation: Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles 90095-7054, USA.
authors.forename: Denise S
authors.initials: DS
authors.lastname: Tai
authors.forename: Johnny
authors.initials: J
authors.lastname: Hong
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Busuttil
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Lipshutz
mesh_terms: D000328:Adult; D001739:BK Virus / Q000472:pathogenicity; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation; D016015:Logistic Models; D008297:Male; D016035:Pancreas Transplantation; D027601:Polyomavirus Infections / Q000150:complications; D011183:Postoperative Complications; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014412:Tumor Virus Infections / Q000150:complications