Changes in quality of life, health status, and other patient-reported outcomes following Simultaneous Pancreas and Kidney Transplantation (SPKT): a quantitative and qualitative analysis within a UK-wide programme

We examined quality of life (QoL) and other patient-reported outcome measures (PROMs) in 95 Simultaneous Pancreas and Kidney Transplant (SPKT) recipients and 41 patients wait-listed for SPKT recruited to the UK Access to Transplantation and Transplant Outcome Measures (ATTOM) programme. Wait-listed patients transplanted within 12 months of recruitment (n=22) were followed 12-months post-transplant and compared with those still wait-listed (n=19) to examine pre-to-post-transplant changes. Qualitative interviews with ten SPKT recipients 12-months post-transplant were analysed thematically. Cross-sectional analyses showed several better 12-month outcomes for SPKT recipients compared with those still wait-listed, a trend to better health utilities but no difference in diabetes-specific QoL or diabetes treatment satisfaction. Pre- to post-transplant, SPKT recipients showed improved treatment satisfaction, well-being, self-reported health, generic QoL and less negative impact on renal-specific QoL (ps<0.05). Health-utility values were better overall in transplant recipients and neither these nor diabetes-specific QoL changed significantly in either group. Pre-emptive transplant advantages seen in 12-month cross-sectional analyses disappeared when controlling for baseline values. Qualitative findings indicated diabetes complications, self-imposed blood-glucose monitoring and dietary restrictions continued to impact QoL negatively post-transplant. Unrealistic expectations of SPKT caused some disappointment. Measuring condition-specific PROMs over time will help in demonstrating the benefits and limitations of SPKT.