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SPK Transplant T1DM — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateEndocrinologySPK Transplant T1DMRACP Adult Medicine

A 50-year-old woman with type 1 diabetes and end-stage renal disease has severe brittle diabetes with recurrent DKA and severe hypoglycaemia despite HCL pump therapy. She is being assessed for a combined pancreas-kidney transplant (SPK). She has no contraindications. What is the expected benefit of SPK?

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Correct answer: A — Cure of both diabetes and ESKD — insulin independence + renal function restoration

Simultaneous pancreas-kidney transplant (SPK) for T1DM + ESKD provides: (1) insulin independence (~85% pancreas graft function at 5 years), (2) renal function restoration (95% kidney graft survival at 5 years), (3) halts/reverses diabetic complications (neuropathy, retinopathy improve), and (4) improved quality of life. SPK has the best pancreas graft survival of all pancreas transplant categories. 5-year patient survival >90%. Requires lifelong immunosuppression. SPK is the treatment of choice for T1DM + ESKD in suitable candidates.

Reference: TSANZ – 2024 – Pancreas-Kidney Transplant; ADS 2024