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Background The beneficial influence of kidney (KTx) or simultaneous pancreas and kidney transplantation (SPK) on quality of life (QOL) in patients with end-stage kidney disease caused by type 1 diabetes mellitus was confirmed in many studies. The aim of this study was to identify factors that influence QOL of patients in long-term follow-up after SPK or KTx. Methods Twenty-seven SPK and 26 KTx patients with good function of transplanted organs at least 1 year after transplantation were enrolled into the analysis. To estimate QOL of the recipients the Kidney Disease and Quality of Life Short Form was applied. Results Within the whole analyzed group, the necessity of exogenous insulin administration correlated ( P < .05) with symptom/problem list (γ = −0.35), effects of kidney disease (−0.38), cognitive function (−0.47), sleep (−0.42), overall health (−0.47), physical functioning (−0.61), role-physical (−0.32), pain (−0.50), general health (−0.32), emotional well-being (−0.31), role-emotional (−0.36), social function (−0.33), energy/fatigue (−0.44), and the SF-12 physical composite (−0.44). History of cardiovascular episode correlated ( P < .05) with symptom/problem list (γ = −0.59), effects of kidney disease (−0.46), burden of kidney disease (−0.56), sleep (−0.54), social support (−0.51), physical functioning (−0.55), role-physical (−0.70), pain (−0.60), general health (−0.57), emotional well-being (−0.45), role-emotional (−0.95), social function (−0.58), energy/fatigue (−0.59), SF-12 physical composite (−0.45), and SF-12 mental composite (−0.83). Conclusions Exogenous insulin administration and history of cardiovascular episode are the most important factors influencing QOL in patients after SPK or KTx, particularly worsening its physical components. [ABSTRACT FROM AUTHOR]

Background Kidney transplantation (KTx) markedly reduces mortality in patients with end-stage kidney disease (ESKD) caused by type 1 diabetes mellitus (T1DM). The outstanding issue is whether transplantation should be limited only to KTx, with further insulinotherapy, or combined with pancreas transplantation in patients with ESKD/T1DM. The goal of this study was to compare the results of simultaneous pancreas–kidney transplantation (SPKTx) and deceased donor KTx and to identify factors affecting patient and kidney graft survival in patients with ESKD/T1DM. Methods Eighty-seven deceased donor KTx and 66 SPKTx operated on in the Silesia region of Poland between 1998 and 2013 were included in the retrospective analysis. Results During the mean 6.7 ± 3.6 years of follow-up, fewer cardiovascular episodes were observed in SPKTx recipients than in KTx recipients (1.5% vs 12.6%; P < .05). Five-year patient survival (80.7% in SPKTx vs 77.5% in KTx) and kidney graft survival (66.1% in SPKTx vs 70.4% in KTx) did not differ between study groups. There were no differences in patient survival (log-rank test, P = .99) or kidney graft survival ( P = .99) based on Kaplan-Meier curves. Multivariable Cox proportional hazard analysis failed to identify factors explaining patient and kidney graft survival. Five-year pancreas graft survival was 58.9%. SPKTx recipients had significantly higher estimated glomerular filtration rates during the 7-year posttransplant period and less frequently developed proteinuria (6.1% vs 23%; P < .01). Conclusions Pancreas transplantation reduced cardiovascular risk and prevented the development of proteinuria but did not improve patient and kidney graft survival in recipients with T1DM in the 7-year follow-up period. [ABSTRACT FROM AUTHOR]