Treating Renal Failure and Diabetes with Simultaneous Pancreas Kidney Transplantation
For most patients with renal failure who also have diabetes mellitus, a simultaneous pancreas kidney transplant, or SPK, offers greater benefits than kidney transplant alone. About 90 percent of pancreas transplants today are performed in the context of an SPK.
Two-for-One Cure Often Justifies SPK
Because a kidney transplant requires patients to take immunosuppressant drugs, which carry their own risks, receiving the added benefit of treated diabetes helps tip the risk-benefit assessment in favor of SPK. For patients with diabetes mellitus and renal failure, an SPK is the preferred treatment of the multidisciplinary team at the University of Maryland Medical Center (UMMC). After 10 years, SPK recipients are more likely to be alive, than recipients of a kidney transplant alone even when the isolated kidney came from a living donor.
Treated Diabetes Increases Durability of Kidney Transplant
Transplanting a kidney without effective control of underlying diabetes may eventually lead to the failure of the donor kidney, especially if diabetes led to failure of the native kidneys. However, because the pancreas transplant treats insulin-dependent diabetes, patients and their physicians have greater confidence that the kidney transplant will enjoy longer durability.
SPK Time to Transplant Is a Fraction of Kidney Alone
Listing for an SPK can dramatically shorten time to transplant. As of August 2017, there are more than 114,000 individuals on solid organ waiting lists, and more than 4 out of 5 of them need kidneys. It is now typical for patients without a living donor to wait five to six years to receive a kidney. However, because the pancreas list is very short and pancreases and kidneys almost always come from the same donor – although living donor kidneys may be used too – with an SPK, median time to transplant is about 90 days at the University of Maryland.
UMMC a High-volume Center for Pancreas Transplant
Pancreas transplantation is not a common procedure; it is challenging, and the right team must be in place to recover a donor pancreas, assess the organ and perform the transplant – all of which are involved steps. UMMC transplant surgeons are on track to perform 45 of these procedures in 2018, a volume that makes UMMC the second busiest center in the United States for SPKs. UMMC's experience in pancreas transplantation translates into excellent outcomes.
"While outcomes have improved over the past two decades, the average risk of blood clots following an SPK about 5 percent," says Joseph R. Scalea, MD, Assistant Professor of Surgery at the University of Maryland School of Medicine. "At UMMC, our rate is now less than 2 percent."
Dr. Scalea attributes UMMC's success with SPK to better immunosuppression management, improved perioperative care and coordination, and robust postoperative follow-up.
"We receive referrals for SPK from all over the United States," says Dr. Scalea, "and we are committed to working with our regional partners when it comes to ensuring that we procure the highest quality organs for their patients."
To refer a patient for an initial consultation for simultaneous pancreas kidney transplant, complete a referral form or call 410-328-5408 to ask to speak directly to a UMMC transplant surgeon.
- For Referring Physicians - Transplant
- Pancreas and Kidney Transplant at UMMC
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- Scalea JR, Cooper M. Current concepts in the simultaneous transplant of kidney and pancreas. J Intensive Care Med. 2012 Jul-Aug;27(4):199-206.