Analysis of Rejection, Infection and Surgical Outcomes in Type I Versus Type II Diabetic Recipients After Simultaneous Pancreas-Kidney Transplantation

Transpl Int. 2024 Sep 19:37:13087. doi: 10.3389/ti.2024.13087. eCollection 2024.

Abstract

Given the increasing frequency of simultaneous pancreas-kidney transplants performed in recipients with Type II diabetes and CKD, we sought to evaluate possible differences in the rates of allograft rejection, infection, and surgical complications in 298 Type I (T1D) versus 47 Type II (T2D) diabetic recipients of simultaneous pancreas-kidney transplants between 2006-2017. There were no significant differences in patient or graft survival. The risk of biopsy-proven rejection of both grafts was not significantly different between T2D and T1D recipients (HRpancreas = 1.04, p = 0.93; HRkidney = 0.96; p = 0.93). Rejection-free survival in both grafts were also not different between the two diabetes types (ppancreas = 0.57; pkidney = 0.41). T2D had a significantly lower incidence of de novo DSA at 1 year (21% vs. 39%, p = 0.02). There was no difference in T2D vs. T1D recipients regarding readmissions (HR = 0.77, p = 0.25), infections (HR = 0.77, p = 0.18), major surgical complications (HR = 0.89, p = 0.79) and thrombosis (HR = 0.92, p = 0.90). In conclusion, rejection, infections, and surgical complications after simultaneous pancreas-kidney transplant are not statistically significantly different in T2D compared to T1D recipients.

Keywords: complication; infection; pancreas-kidney transplantation; rejection; type 2 diabetes.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / surgery
  • Diabetes Mellitus, Type 2* / complications
  • Female
  • Graft Rejection* / etiology
  • Graft Survival*
  • Humans
  • Incidence
  • Infections / epidemiology
  • Infections / etiology
  • Kidney Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Pancreas Transplantation* / adverse effects
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Retrospective Studies
  • Treatment Outcome

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number T35DK062709. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.