Survival benefit of the homologous kidney allograft in simultaneous pancreas-kidney transplants and its potential protective role

Oscar K. Serrano, Raja Kandaswamy, Erik B. Finger

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

The superior death-censored graft survival of the pancreas allograft in simultaneous pancreas kidney transplants (SPK) over pancreas alone transplants (PTA) has long been recognized. Using data from the Scientific Registry of Transplant Recipients (SRTR) and a high-volume pancreas transplant program, we investigated the possible protective role of the kidney allograft in SPK transplants. We analyzed 19 043 primary pancreas transplants between 2000 and 2020, including 735 transplants performed at the University of Minnesota. SPK transplants demonstrated a superior death-censored graft survival over pancreas after kidney (PAK) and simultaneous pancreas and living donor kidney (SPLK) transplants, which both demonstrated better survival than PTA transplants. This effect was not affected by mode or duration of renal replacement therapy prior to transplant. Furthermore, we found that HLA match at the B-locus between the prior kidney and current pancreas allografts demonstrated a protective effect (HR.54; 95% confidence interval.29–1.00), with a 2-antigen match demonstrating superior death-censored graft survival to a 1- or 0-antigen match. We propose that a homologous kidney allograft in SPK transplants affords protection to the pancreas allograft–likely through a combination of better surveillance for rejection and direct immunoprotection offered by the same-donor kidney.

Original languageEnglish (US)
Article numbere14462
JournalClinical Transplantation
Volume35
Issue number11
DOIs
StatePublished - Nov 2021

Bibliographical note

Funding Information:
The data reported here were supplied by the Minneapolis Medical Research Foundation as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as representing the official policy or view of either the SRTR or the U.S. government.

Publisher Copyright:
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Keywords

  • homologous kidney
  • immune protection
  • simultaneous pancreas kidney

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