The impact of pancreas and kidney transplant on cardiovascular risk factors (analyzed by mode of immunosuppression and exocrine drainage).
Davenport, Colin Hamid, Nadira O'Sullivan, Eoin P Daly, Padraig Mohan, Ponnusamy Little, Dilly Thompson, Christopher J Agha, Amar Hickey, David Smith, Diarmuid
Davenport, Colin
Hamid, Nadira
O'Sullivan, Eoin P
Daly, Padraig
Mohan, Ponnusamy
Little, Dilly
Thompson, Christopher J
Agha, Amar
Hickey, David
Smith, Diarmuid
Advisors
Editors
Other Contributors
Date
2011-04-06T14:02:15Z
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adult
Blood Glucose
Cardiovascular Diseases
Cholesterol
Cyclosporine
Diabetes Mellitus, Type 1
Drainage
Female
Graft Rejection
Hemoglobin A, Glycosylated
Humans
Immunosuppressive Agents
Kidney Failure, Chronic
Kidney Transplantation
Male
Mycophenolic Acid
Pancreas Transplantation
Postoperative Complications
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Tacrolimus
Treatment Outcome
Triglycerides
Blood Glucose
Cardiovascular Diseases
Cholesterol
Cyclosporine
Diabetes Mellitus, Type 1
Drainage
Female
Graft Rejection
Hemoglobin A, Glycosylated
Humans
Immunosuppressive Agents
Kidney Failure, Chronic
Kidney Transplantation
Male
Mycophenolic Acid
Pancreas Transplantation
Postoperative Complications
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Tacrolimus
Treatment Outcome
Triglycerides
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
The aim of this study was to determine the cardiovascular (CV) risk factor response in Irish patients with type 1 diabetes following simultaneous pancreas and kidney transplantation (SPK), analyzing response based on mode of immunosuppression and surgical drainage in a uniquely homogenous population.
A retrospective review of SPKs carried out between 1993 and 2005 in the National Renal and Pancreatic Centre of Ireland was performed. Weight, glycated hemoglobin (HBA1c), lipid profile, and blood pressure (BP) were measured pre- and post-operatively.
Fifty-eight SPK patients with functioning grafts were analyzed. Thirty-two were male. Following transplantation, mean HbA1c fell from 8.1 (+/-1.5) to 5.2 (+/-0.5)% (p < 0.0001), total cholesterol from 5.2 (+/-1.2) to 4.5 (+/-1.0) mmol/L (p = 0.0004), serum triglycerides from 1.5 (+/-0.6) to 1.1 (+/-0.6) mmol/L (p < 0.0001), and serum creatinine from 699.3 (+/-273.4) to 162.5 (+/-135.8) mmol/L (p < 0.0001). Systolic and diastolic BP fell from 148.5 (+/-23.3) to 136.9 (+/-22.4) mmHg (p = 0.02), and 84.8 (+/-11.7) to 77.8 (+/-10.4) mmHg (p = 0.003), respectively. Cholesterol reduction was significantly greater in the group that received cyclosporine (n = 29) compared with a tacrolimus and mycophenolic acid mofetil (MMF) combination (1.3 +/- 0.3 vs. 0.2 +/- 0.2 mmol/L, p = 0.003). Choice of exocrine vs. endocrine graft drainage did not affect risk factor response.
SPK resulted in significant improvements both in glucose control and other measured CV risk factors.
A retrospective review of SPKs carried out between 1993 and 2005 in the National Renal and Pancreatic Centre of Ireland was performed. Weight, glycated hemoglobin (HBA1c), lipid profile, and blood pressure (BP) were measured pre- and post-operatively.
Fifty-eight SPK patients with functioning grafts were analyzed. Thirty-two were male. Following transplantation, mean HbA1c fell from 8.1 (+/-1.5) to 5.2 (+/-0.5)% (p < 0.0001), total cholesterol from 5.2 (+/-1.2) to 4.5 (+/-1.0) mmol/L (p = 0.0004), serum triglycerides from 1.5 (+/-0.6) to 1.1 (+/-0.6) mmol/L (p < 0.0001), and serum creatinine from 699.3 (+/-273.4) to 162.5 (+/-135.8) mmol/L (p < 0.0001). Systolic and diastolic BP fell from 148.5 (+/-23.3) to 136.9 (+/-22.4) mmHg (p = 0.02), and 84.8 (+/-11.7) to 77.8 (+/-10.4) mmHg (p = 0.003), respectively. Cholesterol reduction was significantly greater in the group that received cyclosporine (n = 29) compared with a tacrolimus and mycophenolic acid mofetil (MMF) combination (1.3 +/- 0.3 vs. 0.2 +/- 0.2 mmol/L, p = 0.003). Choice of exocrine vs. endocrine graft drainage did not affect risk factor response.
SPK resulted in significant improvements both in glucose control and other measured CV risk factors.
Language
en
ISSN
1399-0012
eISSN
ISBN
DOI
10.1111/j.1399-0012.2009.01066.x
PMID
19732096