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

Détails

ID Serval
serval:BIB_3A593F3DB393
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Islet transplantation improves vascular diabetic complications in patients with diabetes who underwent kidney transplantation: a comparison between kidney-pancreas and kidney-alone transplantation.
Périodique
Transplantation
Auteur(s)
Fiorina P., Folli F., Maffi P., Placidi C., Venturini M., Finzi G., Bertuzzi F., Davalli A., D'Angelo A., Socci C., Gremizzi C., Orsenigo E., La Rosa S., Ponzoni M., Cardillo M., Scalamogna M., Del Maschio A., Capella C., Di Carlo V., Secchi A.
ISSN
0041-1337 (Print)
ISSN-L
0041-1337
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
75
Numéro
8
Pages
1296-1301
Langue
anglais
Notes
Publication types: Comparative Study ; Journal ArticlePublication Status: ppublish
Résumé
BACKGROUND: The aim of this study was to evaluate the effects of islet transplantation on patient survival and diabetic vascular complications.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: Successful islet transplantation improves survival, atherothrombotic profile, and endothelial morphology in uremic type 1 diabetic kidney transplant patients.
Mots-clé
Adult, Antithrombin III/analysis, Arteriosclerosis/etiology, Biopsy, Cardiovascular Diseases/mortality, Diabetes Mellitus, Type 1, Diabetic Angiopathies/surgery, Humans, Islets of Langerhans Transplantation, Kidney/physiopathology, Kidney Transplantation, Middle Aged, Protein C/analysis, Risk Factors, Skin/pathology, Survival Analysis, Thrombosis/etiology
Pubmed
Web of science
Création de la notice
07/09/2016 8:05
Dernière modification de la notice
20/08/2019 13:30
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