Clinical outcomes of simultaneous pancreas-kidney transplantation: experience of a single center

抄録

This study evaluated the outcomes of simultaneous pancreas-kidney transplantation (SPK) at Fukushima Medical University between 2001 and 2024.　We retrospectively reviewed ten adult patients who underwent SPK.　We aimed to clarify the important aspects of patient management in patients undergoing SPK, focusing on perioperative outcomes and long-term complications.

The median postoperative observation period was 1,968 days.　Postoperative complications were observed in all patients.　Most were classified as Clavien-Dindo (CD) grade I or II, but major complications, including CD grade IIIa or higher, were observed in four patients (40%) with zero mortality.　Despite the loss of one kidney graft due to primary non-function, the 5-year survival rates for both patients and pancreatic grafts remained at 100%.　However, there was one case each of pancreatic graft loss, kidney graft loss, and patient death after 5 years post-transplantation, all attributed to late-onset complications, including recurrent type 1 diabetes, focal segmental glomerulosclerosis, and cardiovascular disease.

The short-term outcomes of SPK at our institution were favorable, with a trend toward a reduction in the comprehensive complication index (CCI) observed in the latter five cases compared with the first five cases, suggesting potential improvements in perioperative management.　Long-term monitoring and collaboration with physicians are essential to enhance patient outcomes.