title: Epidermal innervation in type 1 diabetic patients: a 2.5-year prospective study after simultaneous pancreas/kidney transplantation.
abstract: OBJECTIVE
  To assess the effect of normoglycemia following simultaneous pancreas/kidney transplantation (SPK) on neurological function and intraepidermal nerve fiber density (IENFD) in patients with type 1 diabetes.
  
  
  METHODS
  We performed vibration perception threshold (VPT) testing and autonomic function testing (AFT) and assessed IENFD in skin biopsies from the lower thigh and upper calf in 14 healthy control subjects and 18 patients with type 1 diabetes at the time of and at 21-40 (median 29) months post SPK.
  
  
  RESULTS
  At baseline, significantly increased VPTs, pathological AFT results, and severe reduction in IENFD were present in SPK recipients. After SPK, an increase of IENFD in the thigh of more than one epidermal nerve fiber per millimeter was noted in three patients (median 4.1, range 1.9-10.2), but changes were not significant for the group as a whole.
  
  
  CONCLUSIONS
  We conclude that either irreversible nerve damage might be present in some SPK recipients or that longer periods of normoglycemia might be needed to allow nerve regeneration.
authors.affiliation: Diabetes and Transplant Centers, Prague, Czech Republic. petr.boucek@ikem.cz
authors.forename: Petr
authors.initials: P
authors.lastname: Boucek
authors.forename: Terezia
authors.initials: T
authors.lastname: Havrdova
authors.forename: Ludek
authors.initials: L
authors.lastname: Voska
authors.forename: Alena
authors.initials: A
authors.lastname: Lodererova
authors.forename: Lan
authors.initials: L
authors.lastname: He
authors.forename: Frantisek
authors.initials: F
authors.lastname: Saudek
authors.forename: Kvetoslav
authors.initials: K
authors.lastname: Lipar
authors.forename: Milos
authors.initials: M
authors.lastname: Adamec
authors.forename: Claudia
authors.initials: C
authors.lastname: Sommer
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000097:blood / Q000473:pathology / Q000601:surgery*; D003929:Diabetic Neuropathies / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D009412:Nerve Fibers / Q000502:physiology; D016035:Pancreas Transplantation; D010465:Perception; D011446:Prospective Studies; D012016:Reference Values; D012867:Skin / Q000294:innervation* / Q000473:pathology; D014732:Vibration
chemical_list: D001786:Blood Glucose