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
Authors' conclusion
SPKTx 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.
Study context
- Population
- Adults with T1D and end-stage kidney disease; Embase, MEDLINE and Scopus searched to 23 February 202515 studies
- Participants
- 564 vs 419
- Comparison
- SPKTx vs KTx
- SPKTxn = 564
- KTxn = 419reference
- Outcome
- Post-transplant metabolic outcomes
- Follow-up
- Post transplant
Methodological detailsNewcastle-Ottawa scale quality assessment, Limited by lack of subgroup data, lack of randomised studies and paucity of reported lifestyle factors
- Newcastle-Ottawa scale quality assessment
- Limited by lack of subgroup data, lack of randomised studies and paucity of reported lifestyle factors
Pooled result
As reported in the abstract
- I2=37%
- MD, total cholesterol −0.41 mmol/l (95% CI −0.60 to −0.22); P < 0.01
- I2=86%
- MD, triglyceride (TG) −0.76 mmol/l (95% CI −1.02 to −0.49); P < 0.01
- I2=15%
- MD, LDL −0.28 mmol/l (95% CI −0.42 to −0.14); P < 0.01
- I2=98%
- MD, HbA1c −28.79 mmol/mol (95% CI −35.75 to −21.82); P < 0.01
- Post-transplant metabolic outcomes
- MD, HbA1c −2.61 % (95% CI −3.05 to −2.16); P < 0.01
- I2=90%
- MD, creatinine −21.54 μmol/l (95% CI −39.23 to −3.85); P = 0.02
Further pooled results
Mean antihypertensive agents per participant, SPKTx post vs pre transplant
- Post SPKTx vs pre transplant
- 1.0 vs 2.5; p<0.01
- Not significantly different from post-KTx
HbA1c after KTx vs pre KTx
- Post KTx vs pre KTx
- 69 mmol/mol [8.5%] vs 53 mmol/mol [7.0%], p<0.01
Macrovascular disease (coronary artery disease (CAD), cerebrovascular disease (CeVD), peripheral vascular disease (PVD)) · post transplant
- Progression of CAD, CeVD and PVD in both groups post transplant
- PVD: more than twofold increase in amputations and revascularisations post transplant
- No difference in post-transplant frequency of CAD, CeVD or PVD between SPKTx and KTx
Original publication
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. Diabetologia. Published 29 August 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →