Endocrine Abstracts

Introduction: Simultaneous pancreatic kidney transplantation (SPK) has become the therapy of choice in patients with type 1 diabetes mellitus (DM) and end stage diabetic nephropathy.

Methods: An analysis was performed of type 1 diabetic patients with end stage diabetic nephropathy who received treatment with SPK between 2001–2011 in the South West of Ireland, population 663,176 with a prevalence of type 1 DM in this region estimated to be 0.3%. Data was obtained from the South West of Ireland nephrology database.

Results: Between 2001 and 2011, 35 type 1 diabetics with end stage diabetic nephropathy were treated in the South West of Ireland. 14 have undergone SPK and 8 have undergone kidney transplant alone. 3 patients are currently awaiting SPK and 3 awaiting kidney transplant alone. Seven out of 35 died while receiving dialysis. The mean age of the SPK group was 41 years ±9.80. The mean duration of disease at time of SPK was 29.58 years ±9.48. The average waiting time from being placed on the transplant pool to transplantation was 19 months ±12.38. No mortality was reported post SPK. There was loss of pancreatic allograft in 4 patients: 2 in the immediate post-operative period (< 10 days post op), 1 at 9 years post-transplant and 1 at ten years post-transplant. The mean pre-operative HbA1C was 9.6% and 12 months post-operatively was 6.2% in the 12 functioning pancreatic allografts. Twelve month mean post-operative GFR in the 14 patients was 55mL/min/1.73m2.

Conclusion: SPK is the treatment of choice in type 1 diabetics with end stage diabetic nephropathy. SPK is performed in a single centre in Ireland, with 12 month pancreas allograft survival rates in our cohort of 79% which is comparable to international centres of excellence.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector