Outcomes After Pancreas Transplant
The rates of patient survival are approximately 97% at 1 year, 92% at 3 years and over 80% at 5 years after SPK transplantation. Similar patient survival rates are reported for PAK and PTA recipients.
Graft survival is variable, depending on the type of pancreas transplant performed. According to recent SRTR data (2018), 1- and 5-year pancreas graft survival rates for SPK are 89% and 80%, respectively. For PAK and PTA recipients, 1 and 5-year pancreas graft survival rates are 86% and 66% versus 84% and 60%, respectively. Pancreas graft survival continues to be higher for SPK grafts than that for solitary pancreas grafts. Graft survival and insulin independence rates for all categories continue to improve.
Simultaneous pancreas-kidney (SPK) transplant has been shown to improve the survival rate compared with cadaveric kidney transplant alone in patients with type 1 diabetes and chronic kidney disease.
Effect on Secondary Complications of diabetes
Normalization of glycemic control may benefit the long-term retinal, nephrologic, neurologic, and macrovascular complications of diabetes.
Successful pancreas transplantation has been shown to eventually reverse established lesions of diabetic nephropathy by 10 years post-transplant.
There is stabilization and, in some cases, improvement in peripheral sensory-motor and autonomic diabetic neuropathy.
Improvements in early-stage non-proliferative diabetic retinopathy and laser-treated proliferative lesions have been seen, even within short periods of follow-up.
Salutary effects on cardiovascular risk factors and amelioration of cardiac morphology and functional cardiac indices have been seen within the first post-transplant year. With longer follow-up (> 5 years), SPK recipients with functioning pancreas grafts were found to have less progression of coronary atherosclerosis and reversal of changes of microangiopathy.
The overall mortality benefit of pancreas transplantation is well-documented. Studies have demonstrated that patients rate their lives better after pancreas transplantation than before mainly owing to freedom from frequent blood glucose monitoring, intensive insulin therapy, and hypoglycemic episodes.
