Simultaneous Pancreas-Kidney Transplantation Versus Living Donor Kidney Transplantation Alone: an Outcome-Driven Choice?

AbstractPurpose of ReviewThe choice of optimum transplant in a patient with type 1 diabetes mellitus (T1DM) and chronic kidney disease stage V (CKD V) is not clear. The purpose of this review was to investigate this in more detail —in particular the choice between a simultaneous pancreas-kidney transplantation (SPKT) and living donor kidney transplantation (LDKT), including recent evidence, to aid clinicians and their patients in making an informed choice in their care.Recent FindingsAnalyses of large databases have recently shown SPKT to have better survival rates than a LDKT in the long-term, despite an early increase in morbidity and mortality in SPKT recipients. This survival advantage has only been shown in those SPKT recipients with a functioning pancreas and not those who had early pancreas graft loss.SummaryThe choice of SPKT or LDKT should not be based on patient and graft survival outcomes alone. Individual patient circumstances, preferences, and comorbidities, among other factors should form an important part of the decision-making process. In general, an SPKT should be considered in those patients not on dialysis and LDKT in those nearing or already on dialysis.
Source: Current Diabetes Reports - Category: Endocrinology Source Type: research

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Publication date: 2019Source: Methods in Microbiology, Volume 46Author(s): Aaron Elbourne, Vi Khanh Truong, Samuel Cheeseman, Piumie Rajapaksha, Sheeana Gangadoo, James Chapman, Russell J. CrawfordAbstractAntimicrobial resistance (AMR) has been identified as one of the greatest threats to human health (Boucher et al., 2009, Bush et al., 2011, Centers for Disease Control and Prevention, 2013, Neu, 1992, Spellberg et al., 2008). Unfortunately, the current rise in AMR has made biofilm-related infections a primary health-care concern, since these biofilms can no longer be effectively treated using conventional antibiotic metho...
Source: Methods in Microbiology - Category: Microbiology Source Type: research
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Source: Journal of Microbiology, Immunology and Infection - Category: Microbiology Source Type: research
PMID: 31109489 [PubMed - in process]
Source: Canadian Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Can J Ophthalmol Source Type: research
PMID: 31109488 [PubMed - in process]
Source: Canadian Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Can J Ophthalmol Source Type: research
PMID: 31109486 [PubMed - in process]
Source: Canadian Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Can J Ophthalmol Source Type: research
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Source: Canadian Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Can J Ophthalmol Source Type: research
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Source: Canadian Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Can J Ophthalmol Source Type: research
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Source: Frontiers in Physiology - Category: Physiology Source Type: research
Abstract In the past, type 2 diabetes mellitus (T2DM) was a contraindication for simultaneous pancreas-kidney transplantation (SPKT) even though it was generally accepted to be an effective treatment option for selected patients with type 1 DM (T1DM) and advanced chronic kidney disease. However, because there may be tremendous overlap in the clinical presentations of T1DM versus T2DM, the presence of detectable C-peptide is no longer considered reliable in determining DM “type.” Experiences with SPKT in uremic patients with detectable pretransplant C-peptide levels with a type 2 diabetes phenotype (old...
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research
Conclusions Elevated urinary MCP-1 concentration measured before clinical findings of DN in women with T1D was associated with changes in kidney interstitial volume, suggesting that inflammatory processes may be involved in the pathogenesis of early interstitial changes in DN.
Source: Nephrology Dialysis Transplantation - Category: Urology & Nephrology Authors: Tags: Chronic Kidney Disease Source Type: research
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