title: Cardiac Assessment of Patients With Type 1 Diabetes Median 10 Years After Successful Simultaneous Pancreas and Kidney Transplantation Compared With Living Donor Kidney Transplantation.
abstract: In recipients with type 1 diabetes, we aimed to determine whether long-term normoglycemia achieved by successful simultaneous pancreas and kidney (SPK) transplantation could beneficially affect progression of coronary artery disease (CAD) when compared with transplantation of a kidney-alone from a living donor (LDK).
  
  
  
  In 42 kidney transplant recipients with functioning grafts who had received either SPK (n = 25) or LDK (n = 17), we studied angiographic progression of CAD between baseline (pretransplant) and follow-up at 7 years or older. In addition, computed tomography scans for measures of coronary artery calcification and echocardiographic assessment of left ventricular systolic function were addressed at follow-up.
  
  
  
  During a median follow-up time of 10.1 years (interquartile range [IQR], 9.1-11.5) progression of CAD occurred at similar rates (10 of 21 cases in the SPK and 5 of 14 cases in the LDK group; P = 0.49). Median coronary artery calcification scores were high in both groups (1767 [IQR, 321-4035] for SPK and 1045 [IQR, 807-2643] for LDK patients; P = 0.59). Left ventricular systolic function did not differ between the 2 groups. The SPK and LDK recipients were similar in age (41.2 ± 6.9 years vs 40.5 ± 10.3 years; P = 0.80) and diabetes duration at engraftment but with significant different mean HbA1c levels of 5.5 ± 0.4% for SPK and 8.3 ± 1.5% for LDK patients (P < 0.001) during follow-up.
  
  
  
  In patients with both type 1 diabetes and end-stage renal disease, SPK recipients had similar progression of CAD long-term compared with LDK recipients. Calcification of coronary arteries is a prominent feature in both groups long-term posttransplant.
authors.affiliation: 1 Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 2 Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 3 Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 4 Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. 5 Department of Radiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 6 Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Jørn Petter
authors.initials: JP
authors.lastname: Lindahl
authors.forename: Richard John
authors.initials: RJ
authors.lastname: Massey
authors.forename: Anders
authors.initials: A
authors.lastname: Hartmann
authors.forename: Svend
authors.initials: S
authors.lastname: Aakhus
authors.forename: Knut
authors.initials: K
authors.lastname: Endresen
authors.forename: Anne
authors.initials: A
authors.lastname: Günther
authors.forename: Karsten
authors.initials: K
authors.lastname: Midtvedt
authors.forename: Hallvard
authors.initials: H
authors.lastname: Holdaas
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Leivestad
authors.forename: Rune
authors.initials: R
authors.lastname: Horneland
authors.forename: Ole
authors.initials: O
authors.lastname: Øyen
authors.forename: Trond
authors.initials: T
authors.lastname: Jenssen
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D018450:Disease Progression; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000209:etiology*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose