Box 1.
Future Research
| • Benefits of early (eGFR >20 ml/min/1.73 m2) SPK transplant in patients with impaired kidney function and rapidly progressive diabetic complications and/or problematic hypo- and hyperglycemia despite advanced automated insulin delivery system. |
| • Patient survival and micro- and macro-vascular diabetic complications in PAK recipients as compared to KTA on an advanced automated insulin delivery systems. |
| • Kidney allograft survival in PAK recipients as compared to KTA on advanced automated insulin delivery systems. |
| • Outcomes of pancreas versus islet transplantation in patients with C-peptide positive diabetes; appropriate selection of candidates for degrees of insulin resistance. |
| • Assessment of pancreas insulin secretory reserve in patients with type 2 diabetes and advanced chronic kidney disease. |
| • Preservation of renal function in PTA/ITA recipients with diabetic kidney disease. |
| • Surgical pancreas transplant related morbidity and long-term outcomes in high risk recipients-e.g. age >55 years, frailty or significant physical impairment, advanced cardiovascular and peripheral vascular disease, etc. |
| • Pancreas allograft outcomes in SPK recipients as compared to the solitary pancreas transplant in terms of alloimmune rejection, autoimmune recurrence, and graft survival. |
| • Long-term risk of sensitization with islet transplantation in IAK recipients. |
| • The impact of CMV disease and its prevention on pancreas and islet transplant outcomes. |
| • Organ donor allocation for pancreas versus islet transplantation. |
| • Randomized studies evaluating efficacy of less nephrotoxic and diabetogenic immunosuppression. |
| • The impact of recipient prehabilitation strategies on long term outcomes. |
| • Organ preservation strategies to reduce ischemia reperfusion injury and optimize isolated islet yields and function. |
| • Comparison of patients reported outcomes between SPK, SIK and KTA recipients, as well as between PAK, IAK and KTA recipeints. |
eGFR – estimated Glomerular Filtration Rate; IAK- islet after kidney; ITA – Islet Transplant Alone; KTA-kidney transplant alone, PAK – Pancreas after kidney; PTA – Pancreas Transplant Alone; SPK – Simultaneous Pancreas-Kidney.