Purpose To investigate the influence of diabetes mellitus on patient and graft survival among renal versus renal-pancreatic recipients. Methods Among 270 renal transplants performed from 1985 to 2002, a total of 204 (75%) were in diabetic patients and 66 (25%) in nondiabetic patients. Among the 204 diabetic patients 161 (60%) kidneys were transplanted simultaneously with a pancreatic graft (SKPT group). The overall group of patient included 164 (61%) men and 106 (39%) women with mean time on dialysis of 31 Â± 21 months (range 0 to 126 months). The mean duration of diabetes was 24 Â± 7 years (range 5 to 51 years). Ninety-nine percent of the patients were on renal replacement therapy (79% hemodialysis and 20% peritoneal dialysis). Results The overall rejection rate was similar (NS). Both patient and kidney graft survival rates were worse in diabetics. Patient survival was 82% at 5 years among patients undergoing SKPT, 60% in diabetics receiving only a kidney, and 88% in nondiabetic transplanted patients. Kidney graft survival at 5 years was 77% in diabetics receiving SKPT, 68% in diabetics receiving a kidney alone, and 82% in nondiabetic patients. Overall patient survival was significantly greater among nondiabetics (P = .002) or in diabetics who received SKPT compared with diabetics who only had a kidney transplant (P = .001). Conclusions This retrospective clinical evaluation confirms that combined pancreas and kidney transplantation should be the first choice to insulin-dependent diabetes mellitus (IDDM) patients with end-stage diabetic nephropathy.
Long-Term survival after kidney and Kidney-Pancreas transplantation in diabetic patients / E. Orsenigo, P. Fiorina, M. Cristallo, C. Socci, E. La Rocca, P. Maffi, L. Invernizzi, V. Zuber, A. Secchi, V. Di Carlo. - In: TRANSPLANTATION PROCEEDINGS. - ISSN 0041-1345. - 36:4(2004 May), pp. 1072-1075.
|Titolo:||Long-Term survival after kidney and Kidney-Pancreas transplantation in diabetic patients|
|Parole Chiave:||diabetes mellitus, type 1; diabetic nephropathies; follow-up studies; graft rejection; humans; kidney failure, chronic; kidney transplantation; middle aged; pancreas transplantation; retrospective studies; survival analysis; survivors; time factors; treatment failure; surgery; transplantation|
|Settore Scientifico Disciplinare:||Settore MED/14 - Nefrologia|
|Data di pubblicazione:||mag-2004|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.transproceed.2004.04.056|
|Appare nelle tipologie:||01 - Articolo su periodico|
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