Comparison before and after transplantation of pancreas-kidney and pancreas-kidney with loss of pancreas--a prospective controlled quality of life study.

Comparison before and after transplantation of pancreas-kidney and pancreas-kidney with loss of pancreas--a prospective controlled quality of life study.

Adang EM, Engel GL, van Hooff JP, Kootstra G.

University Hospital, Maastricht, The Netherlands.

The aim of combined pancreas-kidney transplantation (PKT) in type I diabetic patients with end-stage nephropathy is to restore both functions. Quality of life (QoL) is supposed to improve as a result of this combined transplantation. The objectives of this study are to evaluate QoL before and after PKT and to compare the results with patients in whom the pancreas graft failed soon after the transplantation (PKT-P). The trial is a prospective controlled multicenter study. The control group consists of patients before transplantation and patients who received a PKT in whom the pancreas rejected or thrombosed soon after the transplantation. (PKT-P). A standardized home-based interview is done during dialysis, and repeated 5, 12, and 18 months after transplantation in both groups by the same interviewer. The interview consisted of disease-specific questions (RSCL), general questionnaires (NHP I and II, ABS), the Visual Analogue Scale, a specific questionnaire (Anxiety), and evaluative questions about social support and transplantation. Patients in whom the PKT is successful (n=17) improve significantly or show a strong tendency toward improvement on many aspects of quality of life. Patients in whom the pancreas failed (n=5) still demonstrate improvement, although this is not statistically significant in most cases. Intergroup comparison shows that PKT patients are less anxious, suffer of less itching, have better average daily living conditions, have no diet restrictions, and have a better [correction of have and] global quality of life.