Metabolic and macrovascular outcomes following simultaneous pancreas-kidney transplantation and kidney transplantation alone in recipients with type 1 diabetes mellitus: a systematic review and meta-analysis.
Harsham Choksi, Rowan Klein Nulend, Tess Cooper et al.
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In 30 seconds
This systematic review and meta-analysis compared metabolic and macrovascular outcomes between simultaneous pancreas-kidney transplantation (SPKTx) and kidney transplantation alone (KTx) in adults with type 1 diabetes. The analysis included 15 studies with 564 SPKTx and 419 KTx recipients. SPKTx was associated with lower total cholesterol, triglycerides, LDL, HbA1c, and creatinine levels compared to KTx, but no significant differences in macrovascular disease risk were observed.
Key findings
- SPKTx resulted in a mean difference of -0.41 mmol/l in total cholesterol compared to KTx.
- Triglyceride levels were lower by a mean difference of -0.76 mmol/l following SPKTx.
- HbA1c levels decreased by a mean difference of -28.79 mmol/mol after SPKTx.
- No significant differences in the frequency of CAD, CeVD, or PVD were found between SPKTx and KTx.
Why it matters
Understanding the metabolic advantages of SPKTx over KTx can inform treatment decisions for patients with type 1 diabetes and end-stage kidney disease. However, the lack of difference in macrovascular outcomes highlights the need for ongoing monitoring and management of cardiovascular risks post-transplant.