Long-standing diabetes mellitus and pancreas transplantation: An avenue to increase utilization of an ideal treatment modality

Clin Transplant. 2019 Oct;33(10):e13695. doi: 10.1111/ctr.13695. Epub 2019 Sep 8.

Abstract

Background: Diabetes mellitus (DM) is associated with increased post-operative complications in various surgeries. Little data exist regarding the impact of long-standing DM (>25 years) on outcomes in pancreas transplantation (PTX). The objectives of our study were to determine if long-standing pre-transplant DM (>25 years) was associated with inferior outcomes following PTX.

Methods: Using a 13-year (April, 2000-May, 2012) retrospective analysis, we examined demographic and transplant factors, complications, and outcomes in patients without (Group A) and with (Group B) long-standing (>25 years) pre-PTX DM.

Results: Mean follow-up was 4.2 years. Of 214 consecutive PTX performed, 137 (105 simultaneous PTX (SPK), 25 PTX after kidney (PAK), 7 PTX alone (PTA)) had pre-PTX duration of DM recorded, including 65 in Group A and 72 in Group B. There were no differences between cohorts with respect to demographics. There were no differences in post-PTX surgical/medical complications. There were no differences in outcomes between cohorts (ie, rejection, graft loss or death).

Conclusions: This large-scale analysis demonstrated that PTX can be performed in patients with long-standing DM with excellent patient and graft outcomes. Long-standing DM did not lead to an increased post-PTX infections or complications. Our study suggests that duration of DM should not impact PTX candidacy.

Keywords: complications; diabetes mellitus; pancreas transplantation.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / surgery*
  • Diabetes Mellitus, Type 2 / surgery*
  • Female
  • Follow-Up Studies
  • Graft Rejection / etiology*
  • Graft Survival*
  • Humans
  • Male
  • Pancreas Transplantation / adverse effects*
  • Pancreas Transplantation / methods
  • Pancreas Transplantation / statistics & numerical data*
  • Postoperative Complications / etiology*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Young Adult