Early improvement in cardiac function occurs for pancreas-kidney but not diabetic kidney-alone transplant recipients.
Noninvasive M mode echocardiography with Doppler recording was prospectively performed on type I diabetic recipients of pancreas-kidney (n = 20), pancreas-after-kidney (n = 2), and kidney-alone (n = 11) allografts to determine whether the return of euglycemia by pancreas transplantation in the uremic diabetic person was associated with improved cardiac function. Each patient was studied preoperatively and at 6 and 12 months posttransplant. Echocardiographic parameters which were compared included measures of systolic function (shortening fraction), diastolic function (early/active peak velocity ratio, early/active integral ratio), and left ventricular geometric parameters (interventricular septal thickness, posterior wall thickness, left ventricular mass). The only statistically significant improvement observed for kidney-alone recipients was an increased shortening fraction from baseline (24.91%) to 6 months (32.13%, P < or = 0.0188). In contrast, the pancreas group demonstrated sustained improvement in all outcomes with measures at 12 months consistently showing a significant improvement from baseline which was also significantly better than that reported for the kidney-alone group. This study showed stabilization of cardiac function by echocardiography for diabetic kidney-alone recipients, whereas significant improvement in function occurred for pancreas-kidney recipients. The improvement in cardiac function for pancreas recipients was seen at 6 months with continued improvement evident at 12 months.
Gaber
A O
AO
Department of Surgery, University of Tennessee, Memphis 38163, USA.
el-Gebely
S
S
Sugathan
P
P
Elmer
D S
DS
Hathaway
D K
DK
McCully
R B
RB
Shokouh-Amiri
M H
MH
Burlew
B S
BS
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D003928:Diabetic Nephropathies / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D016035:Pancreas Transplantation / Q000502:physiology*; D013599:Systole; D014511:Uremia / Q000601:surgery; D016277:Ventricular Function, Left
D001786:Blood Glucose