AUTHOR=Malik Abdullah K. , Banks Jenni , Counter Claire , Simmonds Lewis , Tingle Samuel J. , Sinha Sanjay , Muthasamy Anand , Sutherland Andrew , Casey John , Drage Martin , van Dellen David , Callaghan Chris J. , Elker Doruk , Manas Derek M. , Pettigrew Gavin J. , Russell Neil , Sheerin Neil S. , Wilson Colin H. , White Steven A. 
  
TITLE=Locus-specific HLA matching and induction therapy in simultaneous pancreas–kidney transplantation: a national UK cohort study
  
JOURNAL=Transplant International
  
VOLUME=Volume 39 - 2026
  
YEAR=2026
  
URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2026.16427
  
DOI=10.3389/ti.2026.16427
  
ISSN=1432-2277
  
ABSTRACT=The impact of HLA mismatch and induction therapy in simultaneous pancreas-kidney transplantation on outcomes remains incompletely defined. We conducted a retrospective cohort study of 1705 SPK recipients transplanted in the UK between 2007 and 2019. Using national transplant registry data, we analysed the impact of locus-specific HLA mismatch and induction therapy (Alemtuzumab vs. Basiliximab) on pancreas graft survival primarily. Kidney graft and patient survival were also analysed as secondary outcomes. Multivariable Cox proportional hazards models were adjusted for donor, recipient, and transplant variables. Pancreas graft survival at 1- and 10-year post-transplant was estimated to be 88.6% and 72.7%, respectively. Kidney graft and patient survival at 10 years were 76.7% and 75.3%. In adjusted analyses, donor age, cold ischaemic time, and HLA-DQ mismatch were significantly associated with pancreas graft loss. No significant survival difference was seen between Alemtuzumab and Basiliximab induction therapy. Induction therapy and HLA-mismatch status were not associated with pancreas graft outcome in this large registry study.