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| NEUE FORSCHUNGSERGEBNISSE |
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Simultaneous pancreas-kidney transplantation in type 1 diabetes.
The outcome of simultaneous pancreas-kidney (SPK) transplantation in type 1
diabetes has dramatically improved in recent years because of optimized surgical
techniques and new immunosuppressive drug regimens. Normoglycemia is followed by
stabilization or even regression of diabetic lesions, i.e., of heart and kidneys.
However, these effects are only visible after more than five yr of normoglycemia
(achieved by a functioning allograft). This is also a likely explanation for the
conflicting results of studies that investigated patient or kidney graft survival
in SPK transplantation compared to kidney transplantation alone. Most studies had
too short follow-up periods, i.e., less than five yr, to compare effectively
different transplant strategies in patients with type 1 diabetes and therefore
failed to discover a survival benefit in favor of simultaneously transplanted
patients. Recent data now indicate that, with a longer follow-up, there is an
increasing survival benefit for simultaneously transplanted patients compared to
patients who received a single kidney transplant. This is paralleled by the
comparison of simultaneously transplanted patients to patients who received a
single kidney transplant from a living donor. A survival benefit for the combined
procedure was here visible after 10 yr of follow-up. We give a short overview on
SPK transplantation, with a focus on the effects of this procedure on diabetic
complications as well as patient and kidney graft survival.
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Autoren:
Morath, C
; Schmied, B
; Mehrabi, A
; Weitz, J
; Schmidt, J
; Werner, J
; Buchler, M W
; Morcos, M
; Nawroth, P P
; Schwenger, V
; Doehler, B
; Opelz, G
; Zeier, M
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Quelle:
Clin Transplant. 2009 Dec;23 Suppl 21:115-20.
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| Literaturrecherche: U.S.National Library of Medicine's PubMed®
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