Kidney Transplantation in the Diabetic Patient

被引:11
作者
Jose Perez-Saez, Maria [1 ]
Pascual, Julio [1 ]
机构
[1] Hosp Mar, Dept Nephrol, Barcelona 08003, Spain
来源
JOURNAL OF CLINICAL MEDICINE | 2015年 / 4卷 / 06期
关键词
kidney transplantation; diabetes; survival; STAGE RENAL-DISEASE; LIVING DONOR KIDNEY; PANCREAS TRANSPLANTATION; LONG-TERM; ALLOGRAFT SURVIVAL; PREEMPTIVE KIDNEY; CADAVERIC KIDNEY; GLYCEMIC CONTROL; FOLLOW-UP; RECIPIENTS;
D O I
10.3390/jcm4061269
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Diabetes mellitus is one of the most important causes of chronic kidney disease (CKD). In patients with advanced diabetic kidney disease, kidney transplantation (KT) with or without a pancreas transplant is the treatment of choice. We aimed to review current data regarding kidney and pancreas transplant options in patients with both type 1 and 2 diabetes and the outcomes of different treatment modalities. In general, pancreas transplantation is associated with long-term survival advantages despite an increased short-term morbidity and mortality risk. This applies to simultaneous pancreas kidney transplantation or pancreas after KT compared to KT alone (either living donor or deceased). Other factors as living donor availability, comorbidities, and expected waiting time have to be considered whens electing one transplant modality, rather than a clear benefit in survival of one strategy vs. others. In selected type 2 diabetic patients, data support cautious utilization of simultaneous pancreas kidney transplantation when a living kidney donor is not an option. Pancreas and kidney transplantation seems to be the treatment of choice for most type 1 diabetic and selected type 2 diabetic patients.
引用
收藏
页码:1269 / 1280
页数:12
相关论文
共 52 条
[1]   Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease [J].
Becker, BN ;
Brazy, PC ;
Becker, YT ;
Odorico, JS ;
Pintar, TJ ;
Collins, BH ;
Pirsch, JD ;
Leverson, GE ;
Heisey, DM ;
Sollinger, HW .
KIDNEY INTERNATIONAL, 2000, 57 (05) :2129-2135
[2]   Preemptive transplantation for patients with diabetes-related kidney disease [J].
Becker, BN ;
Rush, SH ;
Dykstra, DM ;
Becker, YT ;
Port, FK .
ARCHIVES OF INTERNAL MEDICINE, 2006, 166 (01) :44-48
[3]   Kidney transplantation in type 2 diabetic patients: a comparison with matched non-diabetic subjects [J].
Boucek, P ;
Saudek, F ;
Pokorna, E ;
Vitko, S ;
Adamec, M ;
Koznarova, R ;
Lanska, V .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2002, 17 (09) :1678-1683
[4]   The Impact of Pancreas Transplantation on Kidney Allograft Survival [J].
Browne, S. ;
Gill, J. ;
Dong, J. ;
Rose, C. ;
Johnston, O. ;
Zhang, P. ;
Landsberg, D. ;
Gill, J. S. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2011, 11 (09) :1951-1958
[5]   Kidney allograft and patient survival in type I diabetic recipients of cadaveric kidney alone versus simultaneous pancreas/kidney transplants:: A multivariate analysis of the UNOS database [J].
Bunnapradist, S ;
Cho, YW ;
Cecka, JM ;
Wilkinson, A ;
Danovitch, GM .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2003, 14 (01) :208-213
[6]   Patient survival and cardiovascular risk after kidney transplantation: The challenge of diabetes [J].
Cosio, F. G. ;
Hickson, L. J. ;
Griffin, M. D. ;
Stegall, M. D. ;
Kudva, Y. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2008, 8 (03) :593-599
[7]   Glycemic Control and Survival in Peritoneal Dialysis Patients with Diabetes Mellitus [J].
Duong, Uyen ;
Mehrotra, Rajnish ;
Molnar, Miklos Z. ;
Noori, Nazanin ;
Koyesdy, Csaba P. ;
Nissenson, Allen R. ;
Kalantar-Zadeh, Kamyar .
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2011, 6 (05) :1041-1048
[8]   EFFECTS OF PANCREAS TRANSPLANTATION ON GLOMERULAR STRUCTURE IN INSULIN-DEPENDENT DIABETIC-PATIENTS WITH THEIR OWN KIDNEYS [J].
FIORETTO, P ;
MAUER, SM ;
BILOUS, RW ;
GOETZ, FC ;
SUTHERLAND, DER ;
STEFFES, MW .
LANCET, 1993, 342 (8881) :1193-1196
[9]   Preparation of the pancreas allograft for transplantation [J].
Fridell, Jonathan A. ;
Powelson, John A. ;
Sanders, Carrie E. ;
Ciancio, Gaetano ;
Burke, George W., III ;
Stratta, Robert J. .
CLINICAL TRANSPLANTATION, 2011, 25 (02) :E103-E112
[10]   Kidney and pancreas transplantation [J].
Gaston, RS ;
Alveranga, DY ;
Becker, BN ;
Distant, DA ;
Held, PJ ;
Bragg-Gresham, JL ;
Humar, A ;
Ting, A ;
Wynn, JJ ;
Leichtman, AB .
AMERICAN JOURNAL OF TRANSPLANTATION, 2003, 3 :64-77