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T1DM RRT Choice — ESENeph MCQ

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ModerateTransplantationT1DM RRT ChoiceESENeph

A 30-year-old man with type 1 diabetes for 18 years has eGFR 22 mL/min/1.73m2 and is approaching ESKD. He also has functioning islet cell transplant. What is the best renal replacement option?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Kidney transplant alone from living donor

For a patient with type 1 diabetes and a functioning islet cell transplant (meaning pancreatic endocrine function is already managed), a kidney transplant alone is optimal. SPK would be indicated if there were no functioning pancreatic islets. Living donor kidney transplantation offers the best outcomes (superior graft survival, pre-emptive transplantation). If no living donor is available, listing for deceased donor kidney while on dialysis is appropriate.

Reference: NICE NG107 2018 – RRT; BTS Transplant Guidelines