Choices in kidney transplantation in type 1 diabetes: Are there skeletal benefits of the endocrine pancreas?

Previously, recipients of a simultaneous pancreas-kidney transplant versus a kidney transplant alone were thought to have higher fracture risk. Using a large US registry, Nikkel et al. observed lower rates of fracture hospitalization among patients with type 1 diabetes after simultaneous pancreas-kidney compared with kidney transplantation alone, particularly among men. It is not known whether the apparent benefit of simultaneous pancreas-kidney transplantation is due to improved bone strength or fewer falls, but these findings may influence transplant decision making.