Simultaneous islet-kidney vs pancreas-kidney transplantation in type 1 diabetes mellitus: a 5 year single centre follow-up.

Détails

ID Serval
serval:BIB_1DA87485527A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Simultaneous islet-kidney vs pancreas-kidney transplantation in type 1 diabetes mellitus: a 5 year single centre follow-up.
Périodique
Diabetologia
Auteur(s)
Gerber P.A., Pavlicek V., Demartines N., Zuellig R., Pfammatter T., Wüthrich R., Weber M., Spinas G.A., Lehmann R.
ISSN
0012-186X
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
51
Numéro
1
Pages
110-119
Langue
anglais
Résumé
AIMS/HYPOTHESIS: The aim of this study was to compare the long-term outcomes--in terms of glucose control, renal function and procedure-related complications--of simultaneous islet-kidney (SIK) transplantation with those of simultaneous pancreas-kidney (SPK) transplantation in patients with type 1 diabetes mellitus. METHODS: HbA1c, need for insulin, GFR and complication rate were compared between 13 recipients of SIK and 25 recipients of SPK transplants at the same institution. The mean follow-up was 41 months. RESULTS: Two primary organ non-functions occurred in the SIK group. HbA1c did not differ at any time point during follow-up in the SIK group compared with the SPK group (mean during follow-up 6.3 vs 5.9%). Similarly, kidney function over time was not different between the two groups. A higher rate of insulin independence following SPK transplantation (after 1 year 96 vs 31% in the SIK group) was counterbalanced by a higher rate of serious adverse events (40% relaparotomies vs 0% in the SIK group). CONCLUSIONS/INTERPRETATION: The endogenous insulin production achieved by islet transplantation, combined with optimal insulin therapy, was sufficient for maintaining near-normal glucose levels. In terms of glucose control, islet transplantation provides results comparable to those achieved with pancreas transplantation. However, SPK results in a higher rate of insulin independence, albeit at the cost of more surgical complications. These results have led to a new paradigm in islet transplantation at our institution, where the primary goal is not insulin independence, but good glucose control and avoidance of severe hypoglycaemia.
Mots-clé
Adult, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Glomerular Filtration Rate, Hemoglobin A, Glycosylated, Humans, Insulin, Islets of Langerhans, Islets of Langerhans Transplantation, Kidney Transplantation, Male, Middle Aged, Pancreas Transplantation, Treatment Outcome
Pubmed
Web of science
Open Access
Oui
Création de la notice
18/02/2008 12:55
Dernière modification de la notice
20/08/2019 12:53
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