BACKGROUND AND OBJECTIVES: Transplant options for type I diabetics with @entity454 include simultaneous @entity8 (SPKT), living donor kidney (LDKT), and deceased donor kidney transplant (DDKT). It is unclear whether SPKT offers a survival benefit over LDKT in the current era of transplantation. The authors compared outcomes of kidney transplant recipients with @entity1723 using data from the Organ Procurement and Transplant Network/United Network for Organ Sharing. DESIGN, SETTING, @entity1 , _ MEASUREMENTS: Adult (age 20 to 59) type I diabetics who received a solitary first-time kidney transplant between 2000 and 2007 were studied. Outcomes included overall kidney graft and @entity1 survival. Multivariate analysis was performed using a stepwise Cox proportional hazards model. RESULTS: Kidney graft survival was better for recipients of LDKT compared with SPKT (P = 0.008), although @entity1 survival was similar (P = 0.346). On multivariate analysis, LDKT was associated with lower adjusted risks over 72 mo follow-up of kidney graft failure (HR 0.71; 95% CI 0.61 to 0.83) and @entity1 death (HR 0.78; 95% CI 0.65 to 0.94) versus SPKT. Compared with DDKT, SPKT had superior unadjusted kidney graft and @entity1 survival, partly due to favorable SPKT donor and recipient factors. CONCLUSIONS: Despite more transplants from older donors and among older recipients, LDKT was associated with superior outcomes compared with SPKT and was coupled with the least wait time and dialysis exposure. LDKT utilization should be considered in all type I diabetics with an available living donor, particularly given the challenges of ongoing organ shortage.

Living donor kidney versus simultaneous XXXX diabetics: an analysis of the OPTN/UNOS database.

@entity1 :: ('9606', 'Species') :: ['patient', 'PARTICIPANTS'] @entity8 :: ('MESH:D007674', 'Disease') :: ['pancreas-kidney'] @entity1723 :: ('MESH:D003922', 'Disease') :: ['type I diabetes'] @entity454 :: ('MESH:D007676', 'Disease') :: ['end-stage renal disease']
@entity8 :: (MESH:D007674,Disease) :: ['pancreas-kidney transplant in type I']
