We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Effects of simultaneous pancreas-kidney transplantation and kidney transplantation alone on the outcome of peripheral vascular diseases.
- Authors
Sucher, Robert; Rademacher, Sebastian; Jahn, Nora; Brunotte, Max; Wagner, Tristan; Alvanos, Athanasios; Sucher, Elisabeth; Seehofer, Daniel; Scheuermann, Uwe; Hau, Hans-Michael
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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 HbA1c (P < 0.01) and serum triglycerides (P < 0.01) were significantly lower in patients with SPKT > 8 years after transplantation.<bold>Conclusion: </bold>SPKT favorably slows down development and progression of PVD by maintaining a superior metabolic vascular risk profile in patients with IDDM1.
- Subjects
PANCREAS transplantation; PERIPHERAL vascular diseases; KIDNEY transplantation; TYPE 1 diabetes; CORONARY disease; LEG; SURVIVAL; RESEARCH; RESEARCH methodology; GRAFT survival; DIABETES; RETROSPECTIVE studies; EVALUATION research; MEDICAL cooperation; TREATMENT effectiveness; COMPARATIVE studies; RESEARCH funding; IMMUNOSUPPRESSIVE agents; LONGITUDINAL method; PHARMACODYNAMICS
- Publication
BMC Nephrology, 2019, Vol 20, Issue 1, pN.PAG
- ISSN
1471-2369
- Publication type
journal article
- DOI
10.1186/s12882-019-1649-7