Objectives: To present the experience of the University of Barcelona with simultaneous transplantation of the kidney and pancreas.
Methods: From February, 1983 to September, 1995, we have performed 112 simultaneous kidney and pancreas transplants at the University of Barcelona. Significant changes were made in 1989 relative to the surgical technique, immunosuppression and diagnosis of rejection, consequently the patients have been divided into two groups for analysis: patients treated from 1983 to 1988 (period A) and patients treated from 1989 to 1995 (period B). In both groups we analyzed patient and graft survival, morbidity, effects of SKP transplantation on glucose metabolism, diabetic complications and quality of life.
Results: Patient, kidney and pancreas survival rates were 62.50%, 52.94% and 23.52%, respectively for period A and 86.88%, 82.40% and 71.65% for period B. The metabolic study performed in patients with pancreas functioning for more than one year showed glucose and glycosylated hemoglobin values similar to those of the normal population, although the baseline insulin values were higher (24 +/- 15vs 12 +/- 1 mv/l, p 0.01). The course of retinopathy and visual acuity was better in patients with functioning kidney and pancreas than in the control group. Some aspects of quality of life, such as overall perception of health and physical activity were better in patients with functioning kidney and pancreas than in the control group.
Conclusion: The results of simultaneous kidney and pancreas transplantation have improved significantly in recent years and it is currently the best therapeutic option for patients with type 1 diabetes and end-stage renal disease.