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Lookup NU author(s): Dr Ruth Owen, Emily Thompson, Dr George KourounisORCiD, Dr Christopher Snowden, Professor James ShawORCiD, Professor Colin Wilson, Steven White
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Copyright © 2025 Owen, Reynard, Thompson, Kourounis, Snowden, Maillo-Nieto, Shaw, Wilson and White.The prevalence of diabetes is increasing exponentially, accompanied by an increase in chronic complications, including nephropathy. Kidney transplantation may offer freedom from dialysis but adding a pancreas addresses the underlying disease. Type 2 diabetes mellitus (T2DM) is often described as a condition of insulin resistance and the concurrent beta-cell loss and dysfunction is potentially underestimated. The aim of this review was to provide a critical appraisal of simultaneous pancreas and kidney (SPK) transplantation in recipients with T2DM. The primary concern with SPK transplantation in this group is insulin resistance and the impact of obesity on outcomes. Multiple studies have shown comparable graft survival (GS), patient survival and complication rates when comparing T2DM and T1DM recipients. Furthermore, patients with T2DM had significantly improved GS with SPK when compared to kidney transplantation alone. Despite these findings, SPK transplantation is only selectively used in T2DM patients. Existing literature focuses on comparing transplant outcomes between patients with T1DM and T2DM. We believe the more relevant question is whether a patient with T2DM would derive a meaningful benefit from an SPK, and whether these benefits outweigh the risks, in the context of their other co-morbidities which are not completely similar to those associated with T1DM.
Author(s): Owen R, Reynard J, Thompson E, Kourounis G, Snowden C, Maillo-Nieto A, Shaw J, Wilson C, White S
Publication type: Review
Publication status: Published
Journal: Transplant International
Year: 2025
Volume: 38
Online publication date: 07/10/2025
Acceptance date: 22/09/2025
ISSN (print): 0934-0874
ISSN (electronic): 1432-2277
Publisher: Frontiers Media SA
URL: https://doi.org/10.3389/ti.2025.14772
DOI: 10.3389/ti.2025.14772
PubMed id: 41127477
