Simultaneous pancreas-kidney transplantation: Early complications and long-term outcomes - a single-centre experience

Abstract

Introduction: This study aimed to assess the prevalence and severity of complications after simultaneous pancreas-kidney transplantation (SPKT) and to evaluate its influence on both grafts' long-term results. Methods: This was an observational, retrospective study including 39 consecutive SPKT cases from 2000-2018. Complications were classified into kidney-related and pancreasrelated. The severity of complications was assessed using the modified Clavien-Dindo scale. Kaplan-Meier curve analysis and log-rank tests were used. Cox regression was performed for the multivariate analysis. Results: All 39 recipients had long-term type I diabetes. Twenty-one (53.8%) patients suffered a Clavien-Dindo ≥IIIa complication. Most complications were pancreas-related, with 17 (43.6%) patients suffering from one. Kidney-related major complications were seen in 11 (28.2%) patients. Patient survival at one, five, and 15 years was 89.7%, 87.1%, and 83.9%, respectively; kidney survival was 87.1%, 81.4%, and 73.6%, respectively; and pancreas survival was 76.9%, 71.3%, and 72%, respectively. Pancreas graft survival was influenced by the presence of major postoperative complications; patients and kidney graft survival were not. Conclusions: Complications after SPKT influence pancreas graft survival. Despite the high rate of complications, our results suggest that patients' and kidney graft survival may not be affected by complications.