Pancreatic transplant is the best method for replacing the endocrine function of the gland in patients with type 1 diabetes (DM1). At the end of 2001, more than 17,000 pancreas transplants had been reported to the International Pancreas Transplant Registry. At present, simultaneous pancreaticorenal transplantation is the best treatment for DM1 patients with chronic renal failure. We present the results of simultaneous pancreas-kidney (SPK) transplantation performed in a Brazilian center. METHODS: From 01/2001 to 06/2002, 12 patients with DM1 and associated renal failure received a SPK. Baseline immunosuppression consisted of tacrolimus, mycophenolate mofetil, steroids and induction therapy with basiliximab. RESULTS: With a mean follow-up of 5.7 months (range: 1-18), pancreas and kidney successful rates were respectively 75% and 83%. Survival rate was 83%. There were some major complications including 3 pancreas (25%) and 2 kidney (16%) venous thrombosis and 2 ureteral fistula (16%), but none related to patient death. No episode of rejection occurred in any of the transplanted patients. All patients with successful grafts are insulin-free since transplantation. CONCLUSIONS: These data show that SPK is a safe and effective treatment in the management of DM1 patients with associated renal failure.
Pancreatic transplantation; Diabetes; Insulin; failure