ReviewDiabetologia2026
Metabolic and macrovascular outcomes following simultaneous pancreas-kidney transplantation and kidney transplantation alone in recipients with type 1 diabetes mellitus: a systematic review and meta-analysis.
Review in Diabetologia, 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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Authors and funding
6 authors.
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Abstract
aims/hypothesisSimultaneous pancreas-kidney transplantation (SPKTx) and kidney transplantation alone (KTx) are common treatment modalities for individuals with type 1 diabetes with end-stage kidney disease. This study compared metabolic and macrovascular disease outcomes between SPKTx and KTx in recipients with type 1 diabetes.
methodsWe conducted a systematic search of the Embase, MEDLINE and Scopus databases (last searched 23 February 2025). We included retrospective and case-control studies, owing to a lack of randomised controlled trials in English, with adult patients. We excluded studies reporting on a return to dialysis post transplant, islet-kidney transplantation or separate pancreas-kidney transplants. Bias and study quality were assessed via the Newcastle-Ottawa scale for cohort studies. Demographic and outcome data were synthesised as both categorical and continuous data, with pooled means and summary statistics computed where applicable. Meta-analysis was performed on post-transplant outcomes in studies evaluating total cholesterol (TC), triglyceride (TG) level, HDL, LDL, blood pressure, HbA
resultsA total of 15 studies (n=564 SPKTx, 419 KTx) were included. Meta-analysis demonstrated lower post-transplant TC (mean difference -0.41 mmol/l [95% CI -0.60, -0.22], p<0.01, I CONCLUSIONS/
interpretationSPKTx demonstrates a superior metabolic profile post transplant to that in KTx in recipients with type 1 diabetes. However, this does not translate into differences in the risk of CAD or PVD post transplant, with PVD accounting for the greatest burden of macrovascular disease. REGISTRATION: This protocol has been registered a priori on PROSPERO (CRD42024622408).
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