Effect of pancreas and kidney transplantation on the neuropathic profile in insulin-dependent diabetics with end-stage nephropathy.
From a series of 26 diabetics selected for combined pancreas and kidney transplantations 9 died before surgery was scheduled, one died after surgery and 4 rejected the transplants. The effect of pancreas or kidney transplantation or both on vibratory perception and thermal thresholds, various motor and sensory conduction parameters were studied in 9 of the remaining 12 patients. In 6 both the pancreatic and renal grafts were functioning, in 2 the pancreas was rejected, and in 1 the kidney. At an average follow-up of 41 months after surgery, the mean total score of clinical and electrophysiological improvement in 6 patients with successful combined transplantation was 5.5 +/- 1.6 compared with -4.3 +/- 2.5 in 3 patients with one surviving transplant (P < 0.001). Similarly, the average increase in nerve conduction velocity was 5.8 +/- 1.1 m/s in patients with two functioning grafts whereas it decreased 2.9 +/- 0.7 m/s in those with only one (P < 0.001). The quality of life was considered improved in patients with successful outcome of the two organ transplantations in contrast to the statements of those with only one.
Trojaborg
W
W
Department of Clinical Neurophysiology, National Hospital, Copenhagen, Denmark.
Smith
T
T
Jakobsen
J
J
Rasmussen
K
K
D001341:Autonomic Nervous System / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000601:surgery*; D005071:Evoked Potentials; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D009431:Neural Conduction / Q000502:physiology; D016035:Pancreas Transplantation / Q000502:physiology*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000517:prevention & control*; D011788:Quality of Life; D012684:Sensory Thresholds; D013697:Thermosensing; D014732:Vibration