Foot problems in the diabetic transplant recipient.
Diabetic transplant recipients are at a high risk for foot pathology leading to amputation. This retrospective study from 1/85 to 2/95 examines the risk of foot complications in a population (n = 340) of diabetic renal and combined renal/pancreas transplant recipients. All groups suffered high lower extremity amputation and foot fracture rates. Patients with better circulation and protective sensation intact fared better. Smoking had a profoundly negative effect on the amputation rate as did an amputation prior to the transplant. Patients with pretransplant dialysis were at a higher risk for post-transplant amputation. Concomitant pancreas transplant did not in general significantly affect the risk of amputation or fracture. Females had almost twice the fracture rate of males.
Kalker
A J
AJ
Department of Surgery, University of Wisconsin Hospital & Clinics, Madison 53705, USA.
Pirsch
J D
JD
Heisey
D
D
Sollinger
H W
HW
Belzer
F O
FO
Knechtle
S J
SJ
D'Alessandro
A M
AM
D000328:Adult; D000671:Amputation, Surgical; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000098:blood supply / Q000294:innervation; D005534:Foot Diseases / Q000209:etiology* / Q000601:surgery; D018409:Foot Injuries / Q000209:etiology; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects; D011300:Preoperative Care; D011674:Pulse; D012039:Regional Blood Flow / Q000502:physiology; D006435:Renal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012677:Sensation / Q000502:physiology; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects
D007166:Immunosuppressive Agents