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Short and long-term metabolic outcomes in patients with type 1 and type 2 diabetes receiving a simultaneous pancreas kidney allograft.
- Source :
-
BMC Endocrine Disorders . 2/27/2020, Vol. 20 Issue 1, p1-13. 13p. 6 Charts, 2 Graphs. - Publication Year :
- 2020
-
Abstract
- Background: In contrast to insulin-dependent type 1 diabetes mellitus (T1DM), the indication for Simultaneous pancreas-kidney transplantation (SPK) in patients with type 2 diabetes mellitus (T2DM) is still ambiguous and wisely Eurotransplant (ET) only granted transplant-permission in a selected group of patients. However, with regard to improvement of metabolic conditions SPK might still be a considerable treatment option for lean insulin dependent type 2 diabetics suffering from renal disease. Methods: Medical data (2001–2013) from all consecutive T1DM and T2DM patients who received a SPK or kidney transplant alone (KTA) at the University Hospital of Leipzig were analyzed. Donor, recipients and long-term endocrine, metabolic and graft outcomes were investigated for T1DM and T2DM-SPK recipients (transplanted upon a special request allocation by ET) and T2DM patients who received a KTA during the same period. Results: Eighty nine T1DM and 12 T2DM patients received a SPK and 26 T2DM patients received a KTA. Patient survival at 1 and 5 years was 89.9 and 88.8% for the T1DM group, 91.7 and 83.3% for the T2DM group, and 92.3 and 69.2% for the T2DM KTA group, respectively (p < 0.01). Actuarial pancreas graft survival for SPK recipients at 1 and 5 years was 83.1 and 78.7% for the T1DM group and 91.7 and 83.3% for the T2DM group, respectively (p = 0.71). Kidney allograft survival at 5 years was 79.8% for T1DM, 83.3% for T2DM, and 65.4% for T2DM KTA (p < 0.01). Delayed graft function (DGF) rate was significantly higher in type 2 diabetics received a KTA. Surgical, immunological and infectious complications showed similar results for T1DM and T2DM recipients after SPK transplant and KTA, respectively. With regard to the lipid profile, the mean high-density lipoprotein (HDL)- cholesterol levels were significantly higher in T1DM recipients compared to T2DM patients before transplantation (p = 0.02) and remained significantly during follow up period. Conclusion: Our data demonstrate that with regard to metabolic function a selected group of patients with T2DM benefit from SPK transplantation. Consensus guidelines and further studies for SPK transplant indications in T2DM patients are still warranted. [ABSTRACT FROM AUTHOR]
- Subjects :
- *INSULIN therapy
*ACADEMIC medical centers
*GRAFT versus host reaction
*HIGH density lipoproteins
*HOMOGRAFTS
*TYPE 1 diabetes
*KIDNEY transplantation
*LIPIDS
*METABOLIC disorders
*TYPE 2 diabetes
*PANCREAS transplantation
*RISK assessment
*SURVIVAL analysis (Biometry)
*TRANSPLANTATION of organs, tissues, etc.
*TREATMENT effectiveness
*DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 14726823
- Volume :
- 20
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- BMC Endocrine Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 141984424
- Full Text :
- https://doi.org/10.1186/s12902-020-0506-9