Eligibility of diabetic patients receiving dialysis for islet after kidney transplantation.
BACKGROUND
The aim of this study was to assess the selection of candidates among 38 dialyzed diabetic patients referred between January 1, 1998 and December 31 2002 for kidney followed by islet transplantation (IAK). The main criteria of eligibility for possible IAK were as follows: (1) plasma C-peptide negative; (2) need for a kidney graft; (3) kidney plus whole pancreas transplantation not desired by the patient; and (4) acceptable results of postkidney graft preislet transplantation evaluation.


RESULTS
Seventeen of 38 patients with positive C-p diabetes received a kidney graft alone. Among the 21 C-p-negative diabetic patients, 3 were not eligible for kidney transplantation mainly for psychological reasons and 4 were eligible for kidney plus pancreas transplantation. The remaining 14 C-p-negative patients underwent kidney transplantation or had previously undergone kidney transplantation. Among them, 1 had moved away, 1 refused IAK, one had slightly positive stimulation tests, 1 was overweight, 1 had breast cancer, and 1 had postkidney graft complications. Among the remaining 8 of 14 C-p-negative, kidney-engrafted patients listed for IAK, 5 have undergone transplantation, 3 with a pre-Edmonton and 2 with the Edmonton protocol.


CONCLUSIONS
In conclusion among this series of 38 diabetic patients undergoing dialysis, more than 90% were kidney-grafted. Approximately 50% were ineligible for pancreas transplantation or IAK because of a positive C-p, and 20% were enlisted for IAK. These results highlight the importance of C-p determinations in diabetic dialysis patients to identify eligible patients for pancreas transplantation or IAK.
Vantyghem
M C
MC
Endocrinology and Metabolism Department, and INSERM ERIT 0106, Lille University Hospital, Lille, France. mc-vantyghem@chru-lille.fr
Pattou
F
F
Girardot
C
C
Soudan
B
B
Hazzan
M
M
Noel
C
C
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002096:C-Peptide / Q000097:blood; D003928:Diabetic Nephropathies / Q000601:surgery*; D004608:Eligibility Determination; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D006435:Renal Dialysis
D015415:Biomarkers; D002096:C-Peptide