Overcoming diabetic gastroparesis en route to kidney transplant.
Gastroparesis is a debilitating condition that affects a significant number of diabetic patients. Some of these patients have end-stage renal disease and are in need of kidney transplant. Symptoms of gastroparesis include: early satiety, pyrosis, epigastric pain, nausea and vomiting, which may lead to caloric and electrolyte deficiencies as well as significant weight loss. A viable option for diabetic gastroparesis patients who fail first line treatments consisting of dietary changes and gastric prokinetic medications is gastric electrical stimulator (GES) implantation. We present a 41-yr-old man and 35-yr-old woman with diabetic gastroparesis, who were initially deemed unacceptable candidates for renal transplantation because of marked malnourishment and a concern that they would not be able to tolerate immunosuppressant medications. In less than two yr following GES implantation, each patient underwent a successful kidney transplant.
de Csepel
John
J
Department of Surgery, Saint Vincent's Hospital and Medical Center, New York, NY 10011, USA. jdecespel@svcmny.org
Jack
Angela
A
El-Sabrout
Rafik
R
Butt
Khalid
K
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery*; D004599:Electric Stimulation Therapy; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D007813:Laparotomy; D008297:Male