Excellent outcomes of simultaneous pancreas kidney transplantation in patients from rural and urban australia

a national service experience

Stephen E. Thwaites, Bina Gurung, Jinna Yao, Kathy Kable, Paul Robertson, Brendan J. Ryan, Vincent W. T. Lam, Henry C. Pleass, Jeremy R. Chapman, Wayne J. Hawthorne*, Richard D. M. Allen

*Corresponding author for this work

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Simultaneous pancreas and kidney (SPK) transplantation is performed to restore normoglycemia and renal function in patients with type 1 diabetes mellitus and end-stage renal failure. The National Pancreas Transplant Unit (NPTU) in Sydney provides a service to a population spread across 7.4 million km2. We aimed to see if SPK transplantation outcomes differed between recipients from metropolitan (M) centers and those from nonmetropolitan (NM) regions. Methods: Using a prospectively collected database, patient and graft survival were analyzed. Patients were categorized according to region of residence and by distance from the NPTU. Results: Between January 2001 and May 2010, 165 patients underwent first-time SPK transplantation at the NPTU. There were 126 M and 39 NM recipients. Median distance from the NPTU was 732 km for donors (range, 0-3930 km) and 887 km for recipients (range, 1-4114 km). Median follow-up was 5.2 years (range, 1.1-10.3 years). Actuarial 5-year patient survival was 94% in M and 95% in NM groups. At 5 years, non-death-censored pancreas graft survival was 75% and 82% among M and NM patients, respectively, while kidney allograft survival was 88% in M and 92% in NM groups. There was no significant difference in patient and graft survival between groups. Distance of donor and recipient from the NPTU did not influence graft or patient survival. Conclusions: SPK transplantation can be performed with excellent outcomes at a national center with a vast catchment area, irrespective of donor or recipient location.

Original languageEnglish
Pages (from-to)1230-1235
Number of pages6
JournalTransplantation
Volume94
Issue number12
DOIs
Publication statusPublished - 27 Dec 2012
Externally publishedYes

Keywords

  • Kidney transplantation
  • Metropolitan
  • Pancreas transplantation
  • Rural
  • Type 1 diabetes

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