Short and long-term metabolic outcomes in patients with type 1 and type 2 diabetes receiving a simultaneous pancreas kidney allograft
| العنوان: | Short and long-term metabolic outcomes in patients with type 1 and type 2 diabetes receiving a simultaneous pancreas kidney allograft |
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| المؤلفون: | Robert Sucher, Hans-Michael Hau, Maximilian Brunotte, Franz Maximilian Rasche, Elisabeth Sucher, Nora Jahn, Daniel Seehofer, Andri Lederer |
| المصدر: | BMC Endocrine Disorders BMC Endocrine Disorders, Vol 20, Iss 1, Pp 1-13 (2020) |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Blood Glucose, Male, Time Factors, endocrine system diseases, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030232 urology & nephrology, Type 2 diabetes, Endocrine and metabolic long-term results, 030230 surgery, lcsh:Diseases of the endocrine glands. Clinical endocrinology, 0302 clinical medicine, Postoperative Complications, Germany, Diabetic Nephropathies, medicine.diagnostic_test, Incidence, Immunosuppression, General Medicine, Middle Aged, Allografts, Prognosis, Survival Rate, Female, Research Article, Adult, medicine.medical_specialty, Adolescent, Urology, Pancreas transplantation, Type II diabetes, 03 medical and health sciences, Young Adult, Diabetes mellitus, medicine, Humans, Glycated Hemoglobin, Type 1 diabetes, lcsh:RC648-665, business.industry, Type 2 Diabetes Mellitus, nutritional and metabolic diseases, medicine.disease, Kidney Transplantation, Transplantation, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Lipid profile, business, Biomarkers, Follow-Up Studies |
| الوصف: | BackgroundIn contrast to insulin-dependent type 1 diabetes mellitus (T1DM), the indication for Simultaneous pancreas-kidney transplantation (SPK) in patients with type 2 diabetes mellitus (T2DM) is still ambiguous and wisely Eurotransplant (ET) only granted transplant-permission in a selected group of patients. However, with regard to improvement of metabolic conditions SPK might still be a considerable treatment option for lean insulin dependent type 2 diabetics suffering from renal disease.MethodsMedical data (2001–2013) from all consecutive T1DM and T2DM patients who received a SPK or kidney transplant alone (KTA) at the University Hospital of Leipzig were analyzed. Donor, recipients and long-term endocrine, metabolic and graft outcomes were investigated for T1DM and T2DM-SPK recipients (transplanted upon a special request allocation by ET) and T2DM patients who received a KTA during the same period.ResultsEighty nine T1DM and 12 T2DM patients received a SPK and 26 T2DM patients received a KTA. Patient survival at 1 and 5 years was 89.9 and 88.8% for the T1DM group, 91.7 and 83.3% for the T2DM group, and 92.3 and 69.2% for the T2DM KTA group, respectively (p ). Actuarial pancreas graft survival for SPK recipients at 1 and 5 years was 83.1 and 78.7% for the T1DM group and 91.7 and 83.3% for the T2DM group, respectively (p = 0.71). Kidney allograft survival at 5 years was 79.8% for T1DM, 83.3% for T2DM, and 65.4% for T2DM KTA (p ). Delayed graft function (DGF) rate was significantly higher in type 2 diabetics received a KTA. Surgical, immunological and infectious complications showed similar results for T1DM and T2DM recipients after SPK transplant and KTA, respectively. With regard to the lipid profile, the mean high-density lipoprotein (HDL)- cholesterol levels were significantly higher in T1DM recipients compared to T2DM patients before transplantation (p = 0.02) and remained significantly during follow up period.ConclusionOur data demonstrate that with regard to metabolic function a selected group of patients with T2DM benefit from SPK transplantation. Consensus guidelines and further studies for SPK transplant indications in T2DM patients are still warranted. |
| تدمد: | 1472-6823 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e1576ae5df442330939426b0ae03c6c9Test https://pubmed.ncbi.nlm.nih.gov/32106853Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e1576ae5df442330939426b0ae03c6c9 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14726823 |
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