Large single center results of simultaneous pancreas-kidney transplantation in patients with type 2 diabetes.

Studies have found similar outcomes of Simultaneous Pancreas-Kidney transplantation (SPKT) in patients with Type 2 (T2D) and Type 1 diabetes (T1D). However, there are few data evaluating the association of recipient factors such as age, BMI, or pre-transplant insulin requirements with outcomes, thus the criteria for the optimal recipient selection remains unclear. In this study, 284 T1D and 39 T2D patients, who underwent SPKT between 2006-2017 with 1 year of follow-up at minimum, were assessed for potential relationship of pre-transplant BMI and insulin requirements with post-transplant diabetes and pancreatic graft failure. Kaplan-Meier analysis showed similar rates of freedom from post-transplant diabetes (94.7% T2D vs. 92.3% T1D at 1 yr, and 88.1% T2D vs. 81.1% T1D at 5 yrs) and graft survival (89.7% T2D vs. 90.4% T1D at 1 yr, and 89.7% T2D vs. 81.2% T1D at 5 yrs). There was no significant association between BMI or pre-transplant insulin requirements with post-transplant diabetes occurrence in either T1D (p = 0.10, 0.43, respectively) or T2D (p = 0.12, 0.63) patients in the cohort; or with graft failure (T1D: p = 0.40, 0.09; T2D: p = 0.71, 0.28). These observations suggest a less restricted approach to selective use of SPKT in patients with T2D.