Simultaneous pancreas-kidney transplantation: The role in the treatment of type 1 diabetes and end-stage renal disease.
Type 1 diabetes mellitus (DM) is one of the most common and debilitating diseases to affect the world. Many patients are afflicted by microvascular and macrovascular complications, and succumb to end-stage renal disease (ESRD). Although dialysis and insulin therapy provides better glycemic control, it nonetheless significantly decreases a patient's quality of life. Moreover, they cannot reverse ESRD or alleviate complications. Simultaneous pancreas-kidney (SPK) transplantation has revolutionized the way we manage type 1 DM; it provides a physiological means of achieving normoglycemia while rendering patients free of dialysis. Understanding this procedure is important because it is becoming a more common management strategy for patients with type 1 DM. In this review, we will begin with a brief summary of type 1 DM, followed by a comprehensive description of SPK procedure, including the history and technique. We will then present the outcomes of transplantation.
Department of Surgery, Division of Urology; Schulich School of Medicine and Dentistry, Western University, London, ON;
Alex T
AT
Jiang
Department of Surgery, Division of Urology; Schulich School of Medicine and Dentistry, Western University, London, ON;
BHSc
Department of Surgery, Division of Urology, Western University; Multi-Organ Transplant Program, London Health Sciences Center, London, ON;
Neal
N
Rowe
Department of Surgery, Division of Urology, Western University; Multi-Organ Transplant Program; Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Centre; Department of Microbiology and Immunology; Centre for Human Immunology; Western University, London, ON.
Alp
A
Sener
Department of Surgery, Division of Urology, Western University; Multi-Organ Transplant Program; Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Centre; Department of Microbiology and Immunology; Centre for Human Immunology; Western University, London, ON.
Patrick
P
Luke