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The Effects of Pancreas Transplantation on the Course of Secondary Diabetic Complications

Antonio Secchi

Pancreas/kidney-pancreas transplantation (tx) is a procedure still affected by major risk.Positive effects of this procedure on diabetic complications were shown. Here the authorswill discuss the positive effects of combined kidney-pancreas (KP) tx on glucosemetabolism, long-term diabetic complications, and survival. A reduction of diastolic dysfunctionwas observed 4 years after tx in the KP (pre-tx: 73%, post-tx: 26%) but not inthe kidney-alone (KA) group (pre-tx: 88%, post-tx: 77%). Normal endothelial functionand lower intima media thickness were evident in the KP group. Fifty-one percent onlyof the KP group remain hypertensive at 1 year after tx, versus 81% of the KA group. Finally,among uremic type 1 diabetic patients enrolled for transplantation, those who receivedKP, KA, or remained on dialysis showed an actuarial survival at 7 years of 76.2%,63.5%, and 39.6%, respectively. In conclusion, the KP group showed a better survivaland reduced complications than the KA group.

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