Dual Transplant May Increase Type 1 Survival

06/11/08 Type I Diabetes or Juvenile Diabetes

If you are a type 1 diabetic with kidney failure, the findings of a new study may drastically increase your chance of survival.

Patients who underwent kidney and pancreas transplants had a higher 10-year survival rate than patients who only had kidney transplants. The research is published in the online issue of the Journal of the American Society of Nephrology. The results came from a 16-year study project.

One group underwent kidney transplants and the second group received donor kidneys as well as pancreases. The initial survival rates were lower but ultimately the 10-year survival of participants with the dual transplants was significantly higher (49.3 percent versus 37 percent for single transplant) for death from heart disease. Overall, patients with the pancreas/kidney transplant had 45 percent lower odds of death.

While they are not certain why the pancreatic addition improves survival, the study authors suggest control of glucose may be the reason. It would certainly make sense given the effect of an elevated A1C score.

There are several factors to consider when discussing this information. Autopsies of the first transplant patients revealed that graft and organs failed more in the dual transplants than the single kidney transplant. That may be because the technique was quite new at the time and surgeons were using relatively primitive techniques. Like learning to paint a masterpiece, it takes time to develop the technique to necessary for such complicated surgery.

Survival improved as surgeons gained more experience and knowledge about working with the dual transplant. Poor results at the beginning of the study should not be a concern to anyone reading this and wondering about the efficacy of undergoing the procedure.

Type 1 diabetics are far more susceptible to kidney failure than type 2 diabetics. While there is as yet insufficient evidence to indicate pancreatic transplants may be a viable alternative in the future for type 1 patients, it would certainly appear to be a consideration.

Corie Richter is a nurse and physician's assistant who started her career as a health educator. The survivor of a myocardial infarction (heart attack) and partially successful quadruple bypass surgery, she did not let her health challenges hamper her. Neither the limitations of spinal surgery nor of diabetes have deterred her from a mission of service. She now encourages others through writing and speaking engagements to master their disabilities through education and a proactive attitude.