Quality of life after organ transplantation in type 1 diabetics with end-stage renal disease

被引:78
作者
Sureshkumar, KK
Patel, BM
Markatos, A
Nghiem, DD
Marcus, RJ
机构
[1] Allegheny Gen Hosp, Dept Med, Div Nephrol & Hypertens, Pittsburgh, PA 15212 USA
[2] Allegheny Gen Hosp, Dept Gen Surg, Transplantat Serv, Pittsburgh, PA 15212 USA
关键词
quality of life; simultaneous pancreas-kidney transplantation; type 1 diabetes mellitus;
D O I
10.1111/j.1399-0012.2005.00433.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Quality of life (QOL) should be an important consideration while choosing therapeutic options for patients with type 1 diabetes mellitus (DM) and end-stage renal disease (ESRD) including dialysis, cadaver (CKT) or living kidney transplant (LKT) or simultaneous pancreas-kidney (SPK) transplant. Methods: QOL was assessed in four groups of patients with history of type 1 DM and ESRD: recipients of SPK (n = 43), CKT (n = 43), LKT (n = 11) and wait listed (WL) patients (n = 23). Diabetes Quality of Life (DQOL), Short Form-36 (SF-36) and Quality of Well-Being (QWB) questionnaires were utilized. A subset of SPK (n = 19) and CKT (n = 12) recipients underwent longitudinal QOL evaluation. Results: On DQOL questionnaire, SPK group had better satisfaction subscore compared with CKT (1.8 +/- 0.5 vs. 2.2 +/- 0.6, p < 0.01) LKT (1.8 +/- 0.5 vs. 2.4 +/- 0.7, p < 0.05) and WL (1.8 +/- 0.5 vs. 2.6 +/- 0.6, p < 0.001) groups and better impact subscore compared with CKT (1.7 +/- 0.6 vs. 2.1 +/- 0.6, p < 0.05) and WL (1.7 +/- 0.6 vs. 2.3 +/- 0.6, p < 0.01) groups. There were no significant differences on physical/mental composite scores of SF-36. QWB score was better in SPK group vs. WL group (0.62 +/- 0.11 vs. 0.55 +/- 0.04, p < 0.05). Longitudinal decline in satisfaction (2.3 +/- 0.5 vs. 2.6 +/- 0.9, p = 0.058) and impact (2.0 +/- 0.5 vs. 2.2 +/- 0.5, p = 0.019) subscores of DQOL were noted in CKT group. There were no significant changes in the composite scores of SF-36 in both groups. QWB scores declined in the CKT group (0.67 +/- 0.10 vs. 0.61 +/- 0.05, p = 0.01). Conclusion: QOL was better in type 1 diabetics with ESRD following transplantation when compared with remaining on WL. SPK transplantation had significant positive effect on diabetes-related QOL which was sustained longitudinally but it was difficult to show an overall improvement in general QOL.
引用
收藏
页码:19 / 25
页数:7
相关论文
共 32 条
[1]   Diabetic neuropathy after pancreas transplantation: Determinants of recovery [J].
Allen, RDM ;
AlHarbi, IS ;
Morris, JGL ;
Clouston, PD ;
OConnell, PJ ;
Chapman, JR ;
Nankivell, BJ .
TRANSPLANTATION, 1997, 63 (06) :830-838
[2]  
ARIDGE D, 1991, TRANSPLANT P, V23, P1670
[3]  
CHEUNG AHS, 1992, TRANSPLANT P, V24, P866
[4]   Does transplantation produce quality of life benefits? A quantitative analysis of the literature [J].
Dew, MA ;
Switzer, GE ;
Goycoolea, JM ;
Allen, AS ;
DiMartini, A ;
Kormos, RL ;
Griffith, BP .
TRANSPLANTATION, 1997, 64 (09) :1261-1273
[6]   Reversal of left ventricular diastolic dysfunction after kidney-pancreas transplantation in type 1 diabetic uremic patients [J].
Fiorina, P ;
La Rocca, E ;
Astorri, E ;
Lucignani, G ;
Rossetti, C ;
Fazio, F ;
Giudici, D ;
di Carlo, V ;
Cristallo, M ;
Pozza, G ;
Secchi, A .
DIABETES CARE, 2000, 23 (12) :1804-1810
[7]   Effects of kidney-pancreas transplantation on atherosclerotic risk factors and endothelial function in patients with uremia and type 1 diabetes [J].
Fiorina, P ;
La Rocca, E ;
Venturini, M ;
Minicucci, F ;
Fermo, I ;
Paroni, R ;
D'Angelo, A ;
Sblendido, M ;
Di Carlo, V ;
Cristallo, M ;
Del Maschio, A ;
Pozza, G ;
Secchi, A .
DIABETES, 2001, 50 (03) :496-501
[8]   Quality of life and emotional responses in cadaver and living related renal transplant recipients [J].
Griva, K ;
Ziegelmann, JP ;
Thompson, D ;
Jayasena, D ;
Davenport, A ;
Harrison, M ;
Newman, SP .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2002, 17 (12) :2204-2211
[9]  
Gross CR, 1998, CLIN TRANSPLANT, V12, P351
[10]   Impact of transplantation on quality of life in patients with diabetes and renal dysfunction [J].
Gross, CR ;
Limwattananon, C ;
Matthees, B ;
Zehrer, JL ;
Savik, K .
TRANSPLANTATION, 2000, 70 (12) :1736-1746