Skip to main content

07-20-2018 | Type 1 diabetes | Review | Article

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

Current Diabetes Reports

Authors: Vishnu Swaroop Venkatanarasimhamoorthy, Adam D. Barlow

Publisher: Springer US


Purpose of Review

The 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 Findings

Analyses 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.


The 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.

Please log in to get access to this content

Related topics

CME-accredited GLP-1RAs webcast

Learn more about GLP-1RAs with John Wilding, Julie Lovshin and Kamlesh Khunti

CME-accredited GLP-1RAs webcast on real-world data

Led by Melanie Davies, Stewart Harris & Takashi Kadowaki, this on-demand webcast focuses on treatment with GLP-1RAs, based on real-world data, and the emerging landscape of GLP-1RAs in the context of approved guidelines.

Image Credits