Details

Autor(en) / Beteiligte

• Fiorina, Paolo
• Folli, Franco
• Maffi, Paola
• Placidi, Claudia
• Venturini, Massimo
• Finzi, Giovanna
• Bertuzzi, Federico
• Davalli, Alberto
• D'Angelo, Armando
• Socci, Carlo
• Gremizzi, Chiara
• Orsenigo, Elena
• La Rosa, Stefano
• Ponzoni, Maurilio
• Cardillo, Massimo
• Scalamogna, Mario
• Del Maschio, Alessandro
• Capella, Carlo
• Di Carlo, Valerio
• Secchi, Antonio

Titel

Islet transplantation improves vascular diabetic complications in patients with diabetes who underwent kidney transplantation: a comparison between kidney-pancreas and kidney-alone transplantation

Ist Teil von

• Transplantation, 2003-04, Vol.75 (8), p.1296

Ort / Verlag

United States

Erscheinungsjahr

2003

Quelle

MEDLINE

Beschreibungen/Notizen

• The aim of this study was to evaluate the effects of islet transplantation on patient survival and diabetic vascular complications. Thirty-seven type 1 uremic diabetic kidney transplant patients underwent islet transplantation (KI group). Uremic type 1 diabetic kidney-pancreas (KP group, n=162), kidney-alone (KD group, n=42) transplant patients, and uremic type 1 diabetic patients still on hemodialysis (HD+DM group, n=196) constituted the control groups for survival and endothelial morphology. Patient survival was similar in the KI and KP groups and higher than in the HD+DM group (P<0.05). Patients experiencing long-term islet function (KI-successful [KI-s], n=24) showed a better survival (100%, 100%, and 90%) than those in the KI group who lost islet function (KI-unsuccessful [KI-u], n=13) (84%, 75%, and 45%) at 1, 4 and 7 years, respectively (P=0.02). The cardiovascular death rate for the KI group (18%) was similar to the KD group (19%) but lower when the KI-s group is considered alone (5%), and showed a cardiovascular death rate similar to the KP group (8%). The KI-s group showed a good metabolic profile, with reduction of exogenous insulin requirement and persistent C-peptide secretion, as compared with the KI-u group. The endothelial morphology was evaluated with a skin biopsy obtained in all groups. The KI-s and the KP groups demonstrated decreased signs of endothelial injury compared with the KI-u and HD+DM groups. The KI group showed a better atherothrombotic profile than the HD+DM group, with higher levels of natural anticoagulant protein. Successful islet transplantation improves survival, atherothrombotic profile, and endothelial morphology in uremic type 1 diabetic kidney transplant patients.