Pulmonary function in patients with type 1 diabetes before and after simultaneous pancreas and kidney transplantation.
BACKGROUND
Pulmonary function is impaired in type 1 diabetes mellitus and is associated with the quality of metabolic control. Correction of chronic hyperglycemia by pancreas transplantation may ameliorate pulmonary function.


METHODS
Lung volume and diffusing capacity were measured in 75 uremic patients with type 1 diabetes and a long diabetes duration waiting for a simultaneous kidney and pancreas transplantation (SPK). In addition 85 patients after SPK and 20 patients after kidney transplantation alone (KA) were investigated. In a subgroup of 30 patients, data before and after SPK were available for prospective analysis.


RESULTS
Reduced lung volume and diffusing capacity were found in type 1 diabetic patients before transplantation. Nearly all parameters of pulmonary function improved after SPK and KA. A significant change was found for forced expiratory volume at 1 sec (FEV1) and FEV1/forced vital capacity (FVC) (Tiffenau index). A significant amelioration of diffusing capacity was only found in the SPK group but not in the KA group. The prospective investigation revealed significant improvements of pulmonary function after SPK: FEV1 (P=0.001), FVC, (P=0,006), Tiffenau index (P=0.03), and Hb-corrected diffusing capacity (carbon monoxide transfer factor, TCO), P=0.03; transfer coefficient (KCO=TCO corrected for alveolar volume), P=0.01.


CONCLUSIONS
Simultaneous pancreas and kidney transplantation is able to attain long-term normoglycemia and to improve pulmonary function in uremic type 1 diabetic patients.
Dieterle
Christoph D
CD
Department of Internal Medicine, Diabetes Center and Pulmonary Division, Medizinische Klinik Innenstadt, University of Munich, Munich, Germany. christoph.dieterle@med.uni-muenchen.de
Schmauss
Susanne
S
Arbogast
Helmut
H
Domsch
Christoph
C
Huber
Rudolf M
RM
Landgraf
Rüdiger
R
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000502:physiology*; D011184:Postoperative Period; D011300:Preoperative Care; D012016:Reference Values; D012129:Respiratory Function Tests; D014797:Vital Capacity; D014850:Waiting Lists
D006442:Glycated Hemoglobin