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Sucher, R; Rademacher, S; Jahn, N; Brunotte, M; Wagner, T; Alvanos, A; Sucher, E; Seehofer, D; Scheuermann, U; Hau, HM.
Effects of simultaneous pancreas-kidney transplantation and kidney transplantation alone on the outcome of peripheral vascular diseases.
BMC Nephrol. 2019; 20(1):453 Doi: 10.1186/s12882-019-1649-7 [OPEN ACCESS]
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Leading authors Med Uni Graz: Hau Hans-Michael; Sucher Robert
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Abstract:: BACKGROUND: The effects of Simultaneous Pancreas Kidney Transplantation (SPKT) on Peripheral Vascular Disease (PVD) warrants additional study and more target focus, since little is known about the mid- and long-term effects on the progression of PVD after transplantation. METHODS: 101 SPKT and 26 Kidney Transplantation Alone (KTA) recipients with insulin-dependent diabetes mellitus (IDDM) were retrospectively evaluated with regard to graft and metabolic outcome. Special subgroup analysis was directed towards the development and progression of peripheral vascular complications (PVC) (amputation, ischemic ulceration, lower extremity angioplasty/ bypass surgery) after transplantation. RESULTS: The 10-year patient survival was significantly higher in the SPKT group (SPKT: 82% versus KTA 40%; P < 0.001). KTA recipients had a higher prevalence of atherosclerotic risk factors, including coronary artery disease (P < 0.001), higher serum triglyceride levels (P = 0.049), higher systolic (P = 0.03) and diastolic (P = 0.02) blood pressure levels. The incidence of PVD before transplantation was comparable between both groups (P = 0.114). Risk factor adjusted multivariate analysis revealed that patients with SPKT had a significant lower amount (32%) of PVCs (32 PVCs in 21 out of 101 SPKT; P < 0.001) when compared to the KTA patients who developed a significant increase in PVCs to 69% of cases (18 PVCs in 11 out of 26 KTA; P < 0.001). In line mean values of HbA_1c (P < 0.01) and serum triglycerides (P < 0.01) were significantly lower in patients with SPKT > 8 years after transplantation. CONCLUSION: SPKT favorably slows down development and progression of PVD by maintaining a superior metabolic vascular risk profile in patients with IDDM1.
Find related publications in this database (using NLM MeSH Indexing): Adolescent - administration & dosage; Adult - administration & dosage; Aged - administration & dosage; Child - administration & dosage; Diabetes Mellitus - drug therapy, mortality, surgery; Female - administration & dosage; Follow-Up Studies - administration & dosage; Graft Survival - drug effects, physiology; Humans - administration & dosage; Immunosuppressive Agents - pharmacology, therapeutic use; Kidney Transplantation - mortality, trends; Male - administration & dosage; Middle Aged - administration & dosage; Pancreas Transplantation - mortality, trends; Peripheral Vascular Diseases - drug therapy, mortality, surgery; Retrospective Studies - administration & dosage; Survival Rate - trends; Treatment Outcome - administration & dosage; Young Adult - administration & dosage
Find related publications in this database (Keywords): Pancreas transplantation; Kidney transplantation alone; Diabetes mellitus; Peripheral arterial disease; Diabetic vasculopathy; Vascular steal syndrome