Defining kidney allograft benefit from successful pancreas transplant: separating fact from fiction.

Defining kidney allograft benefit from successful pancreas transplant: separating fact from fiction.
Curr Opin Organ Transplant. 2018 Jun 06;:
Authors: Wiseman AC, Stites E, Kennealey P
Abstract
PURPOSE OF REVIEW: To define the natural history of kidney allograft loss related to recurrent diabetes following transplant, and to understand the potential benefit of pancreas transplantation upon kidney allograft survival.
RECENT FINDINGS: A postulated benefit of simultaneous pancreas kidney transplant is that, unlike kidney transplant alone, euglycemia from the added pancreas allograft may confer a nephroprotective benefit and prevent recurrent diabetic nephropathy in the renal allograft. Recent large database analyses and long-term histological assessments have been published that assist in quantifying the problem of recurrent diabetic nephropathy and answering the question of the potential benefits of euglycemia. Further data may be extrapolated from larger single-center series that follow the prognosis of early posttransplant diabetes mellitus as another barometer of risk from diabetic nephropathy and graft loss.
SUMMARY: Recurrent diabetic nephropathy following kidney transplant is a relatively rare, late occurrence and its clinical significance is significantly diminished by the competing risks of death and chronic alloimmune injury. Although there are hints of a protective effect upon kidney graft survival with pancr...

Source: Current Opinion in Organ Transplantation - June 6, 2018 Category: Transplant Surgery Authors: Wiseman AC, Stites E, Kennealey P Tags: Curr Opin Organ Transplant Source Type: research