Solitary pancreas transplantation: preliminary findings about early reduction of proteinuria in incipient or evident diabetic type I nephropathy.
OBJECTIVE
Our work was aimed to evaluate the precocious reduction of proteinuria in patients suffering from diabetes mellitus type 1 with incipient and evident nephropathy after isolated pancreas transplantation (PTA).


METHODS
From December 2000 to March 2003, we followed 24 PTA grafts in 24 patients with diabetes mellitus type 1 (mean age 37.8 years; mean duration of diabetes 24.8 years). The pancreas was transplanted with portal-enteric drainage in 23 patients and systemic-enteric in 1 patient. The immunosuppressive therapy used basilixmab induction and tacrolimus, mycophenolate mophetil (MMF), and low dose steroid maintenance therapy. The renal function, proteinuria, and the glucose metabolic parameters were evaluated before and during the following months after transplant.


RESULTS
All patients are alive and twenty-one have a well-functioning pancreas with three grafts lost. All patients had persistence of normal renal function. Before transplantation 12 patients displayed proteinuria that was clearly reduced in 11 and gone in three patients, all of whom were insulin-independent.


CONCLUSIONS
TPA seems to reduce, and in some cases to regress, the proteinuria associated with early diabetic nephropathy.
Paleologo
G
G
U.O. Nephrology with Transplants, A.O.P., Pisa, Italy.
Tregnaghi
C
C
Bianchi
A M
AM
Barsotti
M
M
Nerucci
B
B
Marchetti
P
P
Coppelli
A
A
Giannarelli
R
R
Boggi
U
U
Vistoli
F
F
Del Prato
S
S
Mosca
F
F
Rizzo
G
G
D000328:Adult; D017668:Age of Onset; D001786:Blood Glucose / Q000032:analysis; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000652:urine*; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007328:Insulin / Q000097:blood / Q000378:metabolism; D000078790:Insulin Secretion; D008297:Male; D016035:Pancreas Transplantation / Q000276:immunology / Q000502:physiology*; D011507:Proteinuria / Q000517:prevention & control*; D016896:Treatment Outcome
D001786:Blood Glucose; D003404:Creatinine; D006442:Glycated Hemoglobin; D007166:Immunosuppressive Agents; D007328:Insulin