Department of Kidney and Pancreas Transplantation, Tianjin First Central Hospital, Tianjin, China.
Transpl Int. 2021 Jul;34(7):1198-1211. doi: 10.1111/tri.13892. Epub 2021 May 21.
In this study, we aimed to compare the metabolic outcomes, renal function, and survival outcomes of simultaneous pancreas and kidney transplantation (SPK) and kidney transplantation alone (KTA) among end-stage kidney disease (ESKD) patients with type II diabetes mellitus (T2DM). Patients with ESKD and T2DM who underwent KTA (n = 85) or SPK (n = 71) in a transplant center were retrospectively reviewed. Metabolic profiles, renal function, and survival outcomes were assessed repeatedly at different follow-up time points. Propensity score procedures were applied to enhance between-group comparability. The levels of renal and metabolic outcomes between SPK and KTA over time were examined and analyzed using mixed-model repeated-measures approaches. The median follow-up period was 1.8 years. Compared with KTA, SPK resulted in superior metabolic outcomes and renal function, with lower levels of glycated hemoglobin (HbA1c; P = 0.0055), fasting blood glucose (P < 0.001), triglyceride (P = 0.015), cholesterol (P = 0.0134), low-density lipoprotein (P = 0.0161), and higher estimated glomerular filtration rate (eGFR; P < 0.001). SPK provided better metabolic outcomes and renal function. The survival outcomes of the recipients and grafts were comparable between the two groups.
在这项研究中,我们旨在比较终末期肾病(ESKD)合并 2 型糖尿病(T2DM)患者中同时进行胰腺和肾脏移植(SPK)与单独肾脏移植(KTA)的代谢结果、肾功能和生存结果。回顾性分析了在移植中心接受 KTA(n=85)或 SPK(n=71)的 ESKD 和 T2DM 患者。在不同的随访时间点,评估代谢谱、肾功能和生存结果。应用倾向评分程序来增强组间可比性。使用混合模型重复测量方法检查和分析 SPK 和 KTA 随时间推移的肾脏和代谢结果水平。中位随访期为 1.8 年。与 KTA 相比,SPK 导致更好的代谢结果和肾功能,糖化血红蛋白(HbA1c;P=0.0055)、空腹血糖(P<0.001)、甘油三酯(P=0.015)、胆固醇(P=0.0134)、低密度脂蛋白(P=0.0161)水平较低,估算肾小球滤过率(eGFR;P<0.001)较高。SPK 提供了更好的代谢结果和肾功能。两组受者和移植物的生存结果相当。