Type 1 Diabetic Patients Have Better Endothelial Function After Simultaneous Pancreas-Kidney Transplantation Than After Kidney Transplantation with Continued Insulin Therapy.
1Medical University of Silesia, Katowice, Poland
2Medical University of Silesia, Katowice, Poland
3Wroclaw Medical University, Wroclaw, Poland
4Medical University of Silesia, Sosnowiec, Poland
5Jagiellonian University, Krakow, Poland
6Medical University of Silesia, Katowice, Poland
Meeting: 2017 American Transplant Congress
Abstract number: 417
Keywords: Kidney/pancreas transplantation
Session Information
Session Name: Concurrent Session: Islet (Auto and Allo) and Pancreas Transplantation
Session Type: Concurrent Session
Date: Tuesday, May 2, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:42pm-3:54pm
Location: E353C
Objective: The improvement of blood glucose metabolism in type 1 diabetic (T1D) patients after simultaneous pancreas-kidney transplantation (SPK) is anticipated to slow progression of vascular damage, as compared to patients after kidney transplantation (KTx). The aim of the study was to perform tests of endothelium function and to measure biochemical markers of its dysfunction in T1D patients with end-stage kidney disease treated with SPK or KTx.
Research Design and Methods: 39 SPK, 39 diabetic KTx and 52 non-diabetic KTx recipients were enrolled into the study. In all participants flow mediated dilation (FMD) was measured and glycated hemoglobin (HbA1C), nitrites and nitrates, asymmetric dimethylarginine, adhesion molecules (sVCAM-1, sICAM-1, sE-selectin), C-reactive protein, tumour necrosis factor-α, and interleukins 6 and 1β were assessed in blood or plasma.
Results: During 58±31 months follow-up period, SPK but not KTx resulted in long-term normalization of HbA1C. FMD response and nitrites plasma concentration in SPK were significantly greater than in KTx [10.4±4.7 vs. 7.7±4.2%, p<0.05 and 0.94 (0.74-1.34) vs. 0.24 (0.20-0.43) [mu]mol/l, p<0.01, respectively]. In the combined group of diabetic patients treated with SPK or KTx, plasma nitrites concentration positively correlated with FMD response (r=0.306, p<0.05) and inversely correlated with HbA1C (r=-0.570, p<0.001). Multivariate regression analysis revealed that nitrites level is explained by HbA1C and eGFR, whereas FMD – only by nitrites.
Conclusions: Normal blood glucose metabolism achieved by simultaneously transplanted pancreas is associated with better nitrites level in T1D renal transplant recipients. FMD is proportional to nitrites plasma concentration in T1D patients after SPK or KTx.
CITATION INFORMATION: Kolonko A, Kowalik A, Ziaja J, Kaminska D, Owczarek A, Kujawa-Szewieczek A, Kusztal M, Badura J, Bozek-Pajak D, Zakrzewska A, Choreza P, Krol R, Chlopicki S, Klinger M, Wiecek A, Chudek J, Cierpka L. Type 1 Diabetic Patients Have Better Endothelial Function After Simultaneous Pancreas-Kidney Transplantation Than After Kidney Transplantation with Continued Insulin Therapy. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Kolonko A, Kowalik A, Ziaja J, Kaminska D, Owczarek A, Kujawa-Szewieczek A, Kusztal M, Badura J, Bozek-Pajak D, Zakrzewska A, Choreza P, Krol R, Chlopicki S, Klinger M, Wiecek A, Chudek J, Cierpka L. Type 1 Diabetic Patients Have Better Endothelial Function After Simultaneous Pancreas-Kidney Transplantation Than After Kidney Transplantation with Continued Insulin Therapy. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/type-1-diabetic-patients-have-better-endothelial-function-after-simultaneous-pancreas-kidney-transplantation-than-after-kidney-transplantation-with-continued-insulin-therapy/. Accessed November 25, 2024.« Back to 2017 American Transplant Congress