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Pancreas Transplant Significantly Reduces Mortality in Type 1 Diabetes Patients

Study shows that receiving a pancreas transplant reduces mortality rate….

A retrospective cohort study was recently published in the journal, Nephrology Dialysis Transplantation, focusing on the mortality rates of patients receiving a pancreas transplant compared to those who were on the waiting list with similar co-morbidities.

Pancreatic transplants have been done since late 1960s in the treatment of type 1 diabetes, however until recent years, the survival of the graft or patient has been poor. Improvements in the surgical technique in grafting and the use of immunosuppressive drugs have made pancreas transplants a viable option in the treatment of type 1 diabetes.

The primary endpoint of the study was mortality in the comparison between pancreas transplant recipients and those on the waiting list. The control group was selected to match the demographic and co-morbid conditions, including renal and cardiovascular, of patients receiving pancreas transplantation. The study was conducted from 2001 through 2009 with a total of 312 patients on the waiting list. 192 patients from said list underwent transplantation. Of those, 148 were recipient of a simultaneous kidney and pancreas transplant, 33 recipients of a pancreas after kidney transplant and 11 recipients of the pancreas transplant alone. 120 patients remained on the waiting list. For each patient, the duration and history of diabetes, kidney function and associated treatment, and other significant medical history was collected for analysis.

The authors reported a 30% overall mortality rate of those patients who had remained on the waiting list. A significantly lower, 9% mortality, was reported in transplant recipients. The one-year mortality rate from date of listing was 4% for the transplant recipients compared with 13% of those on the waiting list. The relative risk of death on the waiting list up to 1 year compared with transplant recipients was 2.67. If patients survived longer than 1 year on the waiting list, their relative risk of death increased to 5.89 compared to transplant recipients.

The study was able to conclude that pancreas transplantation provides increased survival benefits that outweigh the risk of surgery and immunosuppressant drugs. The pancreas transplantation remains a viable treatment option for type 1 diabetes patients.

 "Mortality in diabetes: pancreas transplantation is associated with significant survival benefit." Nephrology Dialysis Transplantation. (2013) 28 (5): 1315-1322. doi: 10.1093/ndt/gfs613