Single Center Experience of Simultaneous Kidney Pancreas Transplants: Benefit for Type 2 Diabetic CKD Patients

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E-Poster

https://storage.unitedwebnetwork.com/files/1099/c667c25e05837ec6fc858166e7b2c0b8.pdf

Abstract Title

First Name *

Georges

Last Name *

Aboukasm

Co-author 1

Mariella Ortigosa-Goggins mariellaogoggins@med.miami.edu University of Miami Miami Transplant Institute Miami

Co-author 2

George Burke gburke@med.miami.edu University of Miami Miami Transplant Institute Miami

Co-author 3

Giselle Guerra gguerra@med.miami.edu University of Miami Miami Transplant Institute Miami

Co-author 4

Co-author 5

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Co-author 7

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Co-author 9

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Introduction

Simultaneous Kidney Pancreas (SPK) transplant is the treatment of choice for patients with Type1DM(T1DM) and chronic kidney disease (CKD). C-peptide level is used to distinguish Type 1 vs Type 2 DM. Patients with Type2DM(T2DM) with CKD and detectable c-peptide level may behave like a T1DM and may benefit from an SPK.

Methods

Single center retrospective review of SPK recipients from 1/2012 to 7/2023, based on detectable(T2DM) vs non-detectable(T1DM) c-peptide levels prior to transplant were analyzed. We compared outcomes between both groups of recipients. We looked at patient survival(PS), pancreas(GSp) and kidney graft survival(GSk), development of Post-transplant DM(PTDM) and metabolic control.

Results

256 recipients of which 40 (15.6%) were categorized as T2DM based on detectable c-peptide levels. Mean follow-up was 3.5yrs, range was from 3m to 11 yrs. There were no differences on baseline characteristics between T1DM and T2DM Table1; 22 pts(10%) of T1DM and 5(12.5%) of T2DM were over 55yo; 25(13.3%) of T1DM and 8(23%) of T2DM had BMI>30.There was no difference in post-transplant c-peptide, A1c or BMI between both groups. T2DM recipients had higher weight gained. No difference in PS, GSp or GSk between the groups. PTDM, A1c>6 was 15.6% in T1DM and 18.2% in T2DM and 8.8% of T1DM had A1c>7, and required hypoglycemic agents. none of T2DM had A1c>7.

Conclusions

In this single center study of SPK recipients, with a mean follow-up of 3.5yrs, T2DM had similar PS, GS, kidney and pancreas, compared to T1DM. BMI was higher after transpalnt for T2DM but there was no diference in the development of PTDM. Centers should consider expanding access to SPK in qualified T2DM.

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