{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T01:42:16Z","timestamp":1788054136067,"version":"build-2784847793"},"reference-count":12,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T00:00:00Z","timestamp":1648598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,7]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Donor and other differences mean understanding drivers of transplant survival for type 1 diabetics is challenging. We aimed to compare outcomes of simultaneous pancreas\u2010kidney transplant over kidney transplant alone for people with end\u2010stage kidney disease (ESKD) and type 1 diabetes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We performed a population\u2010based cohort study comparing outcomes from kidney alone and kidney\u2010pancreas transplants using registry data. Our study population was people in Australia and New Zealand with type 1 diabetes and ESKD who received a kidney transplant in 1984\u20132016. Primary outcomes were time to kidney transplant failure and all\u2010cause death. Secondary outcomes were time to cardiovascular and non\u2010cardiovascular death. We compared adjusted survival using Cox regression (hazard ratio HR and 95% confidence intervals CI).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 1295 type 1 diabetics receiving a transplant, 430 (33%) received deceased donor kidney, 172 (13%) received living donor kidney, and 693 (54%) received pancreas\u2010kidney transplant. Compared to deceased donor kidney, pancreas\u2010kidney recipients had 40% lower rate of kidney transplant failure (adjusted HR 0.60; 95% CI 0.45\u20130.81;\n p<\/jats:italic>\n \u00a0=\u20090.001) and 34% lower mortality (adjusted HR 0.66; 95% CI 0.53\u20130.83;\n p<\/jats:italic>\n \u00a0<\u20090.001), driven by 49% reduction in cardiovascular mortality (adjusted HR 0.51; 95% CI 0.36\u20130.72;\n p<\/jats:italic>\n \u00a0<\u20090.001). Pancreas\u2010kidney recipients had similar reductions in transplant failure and mortality compared to living kidney recipients, after adjusting for transplant timing.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n For people with type 1 diabetes, pancreas\u2010kidney transplant provides improved transplant and overall survival compared to deceased donor kidney alone. Living donor kidneys may perform just as well as pancreas\u2010kidney transplant if waiting times are short.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ans.17663","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T03:18:12Z","timestamp":1648610292000},"page":"1856-1862","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Patient and kidney transplant survival in type 1 diabetics after kidney transplant alone compared to simultaneous pancreas\u2010kidney transplant"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6077-0862","authenticated-orcid":false,"given":"James A.","family":"Hedley","sequence":"first","affiliation":[{"name":"Collaborative Centre for Organ Donation Evidence, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Collaborative Centre for Organ Donation Evidence, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela C.","family":"Webster","sequence":"additional","affiliation":[{"name":"Collaborative Centre for Organ Donation Evidence, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia"},{"name":"Centre for Transplant and Renal Research Westmead Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,30]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"ANZDATA Registry.43rd report chapter 2: prevalence of end stage kidney disease. Australia and New Zealand Dialysis and Transplant Registry Adelaide Australia;2020."},{"key":"e_1_2_11_3_1","unstructured":"ANZDATA Registry.41st report chapter 3: mortality in end stage kidney disease. Australia and New Zealand Dialysis and Transplant Registry Adelaide Australia;2018."},{"key":"e_1_2_11_4_1","unstructured":"The Juvenile Diabetes Research Foundation.Australian Type 1 Diabetes Research Agenda \u2010 Partnering Science Government and the Community. Sydney;2010."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000000832"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2004.04.056"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.00064.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13679"},{"key":"e_1_2_11_9_1","unstructured":"Transplant Society of Australia and New Zealand.Australian KDPI Guide: TSANZ; 2016 [V1.0:]. Available from URL:http:\/\/www.tsanz.com.au\/standalonepages\/documents\/AustralianKDPIINFOv1.0.pdf."},{"key":"e_1_2_11_10_1","first-page":"60","article-title":"European best practice guidelines for renal transplantation. Section IV: long\u2010term management of the transplant recipient. IV.13 analysis of patient and graft survival","volume":"17","author":"EBPG Expert Group on Renal Transplantation","year":"2002","journal-title":"Nephrol. Dial. Transplant."},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/j.2517-6161.1968.tb00724.x","article-title":"A general definition of residuals (with discussion)","volume":"30","author":"Cox DR","year":"1968","journal-title":"J. Royal Stat. Soc."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.200410152"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.17663","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.17663","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.17663","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T03:30:34Z","timestamp":1726889434000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.17663"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,30]]},"references-count":12,"journal-issue":{"issue":"7-8","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1111\/ans.17663"],"URL":"https:\/\/doi.org\/10.1111\/ans.17663","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,30]]},"assertion":[{"value":"2021-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}