Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
Sci Rep. 2023 Jan 2;13(1):49. doi: 10.1038/s41598-022-27203-w.
Simultaneous deceased donor pancreas and living donor kidney transplant (SPLK) has certain advantages over conventional simultaneous pancreas-kidney transplant (SPK) and may be beneficial for overcoming the paucity of organs needed for diabetic patients requiring transplant. We compared the clinical outcomes of patients who underwent either SPK (n = 149) or SPLK (n = 46) in terms of pre- and post-transplantation variables, development of de novo DSA, occurrence of biopsy-proven acute rejection (BPAR), and graft survival rates. There were no significant differences in the baseline characteristics between the SPK and SPLK groups except for the shorter cold ischemic time of kidney grafts, shorter duration of diabetes, older age of pancreas graft-donors, and younger age of kidney graft-donors in the SPLK group. Our results showed that the death-censored pancreas graft survival rate was lower in the SPLK group. In addition, the incidence of BPAR of the pancreas graft was higher in the SPLK group. There was no significant difference in the presence of de novo DSA and the rates of kidney graft failure, kidney BPAR, and mortality. Our results show that SPLK can be considered an alternative option for SPK although higher incidences of BPAR and graft failure of pancreas after SPLK need to be overcome.
胰肾联合移植（SPLK）与传统的胰肾联合移植（SPK）相比具有一定的优势，可能有助于克服糖尿病患者需要移植的器官短缺问题。我们比较了接受 SPK（n=149）或 SPLK（n=46）的患者的临床结果，比较了移植前和移植后的变量、新出现的 DSA、活检证实的急性排斥反应（BPAR）的发生情况以及移植物存活率。除了 SPLK 组的肾移植物冷缺血时间更短、糖尿病病程更短、胰移植物供体年龄更大以及肾移植物供体年龄更小外，两组的基线特征没有显著差异。我们的结果表明，SPLK 组的死亡风险校正后的胰腺移植物存活率较低。此外，SPLK 组胰腺移植物的 BPAR 发生率更高。新出现的 DSA 以及肾移植物衰竭、肾 BPAR 和死亡率无显著差异。我们的结果表明，尽管 SPLK 后胰腺的 BPAR 和移植物失败发生率较高，但 SPLK 可以被认为是 SPK 的替代选择。
