Improved metabolic control and quality of life in seven patients with type I diabetes following islet after kidney transplantation
Improved metabolic control and quality of life in seven patients with type I diabetes following islet after kidney transplantation
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DOI：
10.1097/tp.0b013e318166a27b
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发表时间：
2008-03-27
期刊：
影响因子：
6.2
通讯作者：
Alejandro, Rodolfo
中科院分区：
文献类型：
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作者：
Cure, Pablo;Pileggi, Antonello;Alejandro, Rodolfo
背景血糖控制对I型糖尿病（T1 DM）和终末期肾病（ESRD）患者移植肾存活和功能的有益作用已被认识。在此，我们介绍了7例T1 DM患者肾移植后胰岛（IAK）单中心先导试验的临床结果。移植肾的免疫抑制方案在胰岛移植前6个月转换为西罗莫司+他克莫司方案，以排除对移植肾功能的负面影响。主要终点是移植后达到胰岛素非依赖性。监测临床结果、代谢控制、严重低血糖、肾功能、生活质量（QOL）心理测量指标和不良事件。7例患者在IAK后显示移植物功能改善，代谢控制（Alc、空腹血糖和代谢试验）（14，779 +/-3，800 IEQ/kg）。一年胰岛素依赖性为30%，持续移植功能为86%（C肽阳性）。Alc较基线降低1.95 +/- 0.31%（P
Background. The beneficial effects of glycemic control on both survival and function of transplanted kidneys in patients with type I diabetes mellitus (T1DM) and end-stage renal disease (ESRD) have been recognized.Methods. Herein, we present the clinical outcome of a single-center pilot trial of islet after kidney (IAK) transplantation in seven patients with T1DM. The immunosuppression protocol for the kidney graft was converted to sirolimus+tacrolimus regimen 6 months before islet transplantation to exclude negative effects on kidney graft function. Primary endpoint was achievement of insulin independence after transplantation. Clinical outcome, metabolic control, severe hypoglycemia, kidney function, Quality of Life (QOL) psychometric measures, and adverse events were monitored.Results. Seven patients showed graft function with improved metabolic control (Alc, fasting glycemia, and metabolic tests) after IAK (14,779 +/- 3,800 IEQ/kg). One-year insulin independence was 30% with persistent graft function in 86% (C-peptide-positive). Alc reduction was 1.95 +/- 0.31% from baseline (P