Effects of pancreas-kidney transplantation on diabetic retinopathy.
The effects of pancreas transplantation (PTx) on diabetic retinopathy (DR) are still debated. We studied the course of DR in 48 patients (age: 40 +/- 7 years; males/females 26/22, body mass index (BMI): 23.0 +/- 2.4 kg/m2, duration of diabetes: 24 +/- 8 years) bearing a successful PTx (combined with a kidney). Follow-up ranged 6-60 months (median: 17 months). Before transplantation, according to the Eurodiab Study classification, 12 patients (25%) had nonproliferative retinopathy (NPDR; mild, moderate or severe), and 36 patients (75%) had laser-treated and/or proliferative retinopathy (LT/PDR). During the follow-up, in the NPDR group improvement/deterioration was defined as regression/progression to a lower/higher retinopathy grade; in the LT/PTD group, stabilization was defined as no new neo-vessel formation or development of new lesions requiring laser-treatment. In the NPDR group, five (41.7%) patients improved of one or more lesion grading, three (25%) patients showed no change, and four (33.3%) patients progressed of one grade. In the LT/PDR group, the post-transplant data were: stabilization in 35 (97%) patients, and worsening in one (3%) patient. The number of improved/stabilized patients was significantly higher in the transplanted than in a control group of nontransplanted type 1 diabetic patients. In conclusion, despite a relatively short follow-up period, successful PTx in our cohort of patients was associated with improvement and/or stabilization of DR in the majority of recipients.
Giannarelli
Rosa
R
Department of Endocrinology and Metabolism-Metabolic Unit, University of Pisa, I-56121, Pisa, Italy.
Coppelli
Alberto
A
Sartini
Mariasole
M
Aragona
Michele
M
Boggi
Ugo
U
Vistoli
Fabio
F
Rizzo
Gaetano
G
Del Prato
Stefano
S
Mosca
Franco
F
Marchetti
Piero
P
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery; D003928:Diabetic Nephropathies / Q000097:blood / Q000601:surgery; D003930:Diabetic Retinopathy / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016381:Islets of Langerhans Transplantation; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D006442:Glycated Hemoglobin