Long-term beneficial effect of islet transplantation on diabetic macro-/microangiopathy in type 1 diabetic kidney-transplanted patients.

Details

Serval ID
serval:BIB_5C819AC81963
Type
Article: article from journal or magazin.
Collection
Publications
Title
Long-term beneficial effect of islet transplantation on diabetic macro-/microangiopathy in type 1 diabetic kidney-transplanted patients.
Journal
Diabetes Care
Author(s)
Fiorina P., Folli F., Bertuzzi F., Maffi P., Finzi G., Venturini M., Socci C., Davalli A., Orsenigo E., Monti L., Falqui L., Uccella S., La Rosa S., Usellini L., Properzi G., Di Carlo V., Del Maschio A., Capella C., Secchi A.
ISSN
0149-5992 (Print)
ISSN-L
0149-5992
Publication state
Published
Issued date
2003
Peer-reviewed
Oui
Volume
26
Number
4
Pages
1129-1136
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
OBJECTIVE: Our aim was to evaluate the long-term effects of transplanted islets on diabetic macro-/microangiopathy in type 1 diabetic kidney-transplanted patients.
RESEARCH DESIGN AND METHODS: A total of 34 type 1 diabetic kidney-transplanted patients underwent islet transplantation and were divided into two groups: successful islet-kidney transplantation (SI-K; 21 patients, fasting C-peptide serum concentration >0.5 ng/ml for >1 year) and unsuccessful islet-kidney transplantation (UI-K; 13 patients, fasting C-peptide serum concentration <0.5 ng/ml). Patients cumulative survival, cardiovascular death rate, and atherosclerosis progression were compared in the two groups. Skin biopsies, endothelial dependent dilation (EDD), nitric oxide (NO) levels, and atherothrombotic risk factors [von Willebrand factor (vWF) and D-dimer fragment (DDF)] were studied cross-sectionally.
RESULTS: The SI-K group showed a significant better patient survival rate (SI-K 100, 100, and 90% vs. UI-K 84, 74, and 51% at 1, 4, and 7 years, respectively, P = 0.04), lower cardiovascular death rate (SI-K 1/21 vs. UI-K 4/13, chi(2) = 3.9, P = 0.04), and lower intima-media thickness progression than the UI-K group (SI-K group: delta1-3 years -13 +/- 30 micro m vs. UI-K group: delta1-3 years 245 +/- 20 micro m, P = 0.03) with decreased signs of endothelial injuring at skin biopsy. Furthermore, the SI-K group showed a higher EDD than the UI-K group (EDD: SI-K 7.8 +/- 4.5% vs. UI-K 0.5 +/- 2.7%, P = 0.02), higher basal NO (SI-K 42.9 +/- 6.5 vs. UI-K 20.2 +/- 6.8 micro mol/l, P = 0.02), and lower levels of vWF (SI-K 138.6 +/- 15.3 vs. UI-K 180.6 +/- 7.0%, P = 0.02) and DDF (SI-K 0.61 +/- 0.22 vs. UI-K 3.07 +/- 0.68 micro g/ml, P < 0.01). C-peptide-to-creatinine ratio correlated positively with EDD and NO and negatively with vWF and DDF.
CONCLUSIONS: Successful islet transplantation improves survival, cardiovascular, and endothelial function in type 1 diabetic kidney-transplanted patients.
Keywords
Adult, C-Peptide/blood, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/mortality, Diabetes Mellitus, Type 1/surgery, Diabetic Angiopathies/therapy, Diabetic Nephropathies/surgery, Female, Follow-Up Studies, Humans, Islets of Langerhans Transplantation/mortality, Islets of Langerhans Transplantation/pathology, Kidney Failure, Chronic/etiology, Kidney Failure, Chronic/surgery, Kidney Transplantation/mortality, Kidney Transplantation/pathology, Male, Survival Rate, Time Factors, Treatment Failure, Treatment Outcome
Pubmed
Web of science
Create date
07/09/2016 8:05
Last modification date
20/08/2019 14:15
Usage data