ArticleFrontiers in transplantation2026
Case Report: Simultaneous pancreas-kidney transplantation in MELAS: first reported case with 5-year follow-up.
Article in Frontiers in transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Mitochondrial encephalomyopathy with lactic acidosis, and stroke-like episodes (MELAS) is a rare mitochondrial DNA disorder that, in severe cases, can result in insulin-dependent diabetes and end-stage renal disease (ESRD). While organ transplantation is a potential treatment, documented cases remain scarce. Methods: A 40-year-old patient with dialysis-dependent ESRD and diabetes secondary to MELAS underwent simultaneous pancreas-kidney transplantation. The perioperative and postoperative periods were uncomplicated with only targeted MELAS-specific adaptations to standard protocols. Results: During the 5-year follow-up, the patient maintained excellent kidney allograft function and sustained insulin independence, with no need for dialysis or exogenous insulin therapy. At 5 years, creatinine was 77 µmol/L with an estimated GFR above 90 mL/min/1.73 m Conclusions: SPK transplantation may be feasible in carefully selected patients with MELAS, ESRD, and diabetes, providing durable renal and metabolic graft function at 5 years. To our knowledge, this is the first reported SPK case in MELAS, with extended follow-up.
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