High terminal creatinine donors should not preclude simultaneous kidney and pancreas transplantation

Julia Torabi, Jeffrey Melvin, Alma Rechnitzer, Juan P. Rocca, Maria Ajaimy, Luz Lirano-Ward, Yorg Azzi, Cindy Pynadath, Omar Alani, Enver Akalin, Jay A. Graham

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Simultaneous pancreas and kidney transplantation (SPK) in the setting of end-stage renal disease offers unmatched outcomes in insulin dependent diabetic patients. Donor pool expansion through the transplantation of kidneys with acute kidney injury (AKI) is controversial. Methods: 59 SPK transplants were classified by presence of donor AKI, defined as donor terminal creatinine ≥ 1.5x the initial creatinine or donor terminal creatinine > 4.0 mg/dL. Endpoints included graft and patient survival, delayed graft function (DGF), serum creatinine, glomerular filtration rate (GFR), Hemoglobin A1c (HbA1c) and acute rejection. Results: The donor AKI group (n = 35) had significantly higher rates of DGF (38 v. 9%, p = 0.01). There was no difference in creatinine or GFR at 1, 3, 6 and 12 months. HbA1c was comparable at 3, 6 and 12 months. There was no significant difference in the percentage of patients that required anti-diabetic agents after transplant (14 v. 4%, p = 0.56). Conclusions: We observed increased rates of DGF in SPK recipients with donor AKI. However, equivalent outcomes of pancreas and kidney function in both groups were observed.

Original languageEnglish (US)
Pages (from-to)677-680
Number of pages4
JournalAmerican Journal of Surgery
Issue number4
StatePublished - Apr 2021


  • Delayed graft function
  • Donor acute kidney injury
  • Graft function
  • Simultaneous pancreas kidney transplantation

ASJC Scopus subject areas

  • Surgery


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