#0632

Simultaneous Pancreas-Kidney Transplantation (SPKT) under the National Pancreas Transplant Programme in Singapore: A Twelve-Year Retrospective Case Series

D. Teo¹, J. Hoe¹, W. So², G. Bonney³, H. Sran⁴, A. Vathsala⁴, V. Gan⁵, S. Thangaraju⁶, J. Lu², H. Tiong²

¹National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore
²National University Hospital, Department of Urology, Singapore, Singapore
³National University Hospital, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Singapore, Singapore
⁴National University Hospital, Division of Nephrology, Department of Medicine, Singapore, Singapore
⁵Singapore General Hospital, Department of Urology, Singapore, Singapore
⁶Singapore General Hospital, Division of Renal Medicine, Department of Medicine, Singapore, Singapore

Introduction:

Simultaneous pancreas-kidney transplant (SPKT) has been established as a treatment option internationally for patients with diabetes mellitus (DM) experiencing end-stage renal failure (ESRF) from diabetic nephropathy, improving both insulin production and renal function within a same-setting surgery. However, there is still a paucity of clinical findings following SPKT within Southeast Asia. This is because our National Pancreas Transplant Programme (NPTP) in Singapore is Southeast Asia’s leading and only programme to perform SPKTs. It began in 2012 and to date a total of 7 SPKTs have been performed. Thus the objective of this case series is to present the outcomes of the 7 SPKTs done under the NPTP, jointly led by the National University Hospital and Singapore General Hospital.

Material and methods:

We retrospectively studied these 7 patients who underwent SPKT between September 2012 to May 2024. This consisted of 4 patients with T1DM and 3 patients with T2DM. Relevant baseline and post-transplant outcomes (glycaemic control, renal function, overall survival, graft survival and rejection) were collected. Patients were followed up for at least 1-year post-surgery.

Results:

The baseline demographics and intra-operative parameters are detailed in Table 1, while post-transplant outcomes at annual follow-up for up to 5 years are shown in Table 2. No patients experienced any major complications such as haemorrhage, infection or graft thrombosis. Overall, patients had optimal post-transplant glycaemic control. Regarding rejection, 2 patients experienced chronic allograft nephropathy, but thereafter renal function stabilised. Our 5 year unadjusted pancreatic and kidney graft survival rates were satisfactory at 100%. No reversion to dialysis was required and renal function remained optimal on follow-up. 5-year overall patient survival was also 100%.