Successful long-term kidney-pancreas transplants in diabetic patients with high C-peptide levels.

作者: Truman M. Sasaki , R. Stuart Gray , Robert E. Ratner , Charles Currier , Alex Aquino

DOI: 10.1097/00007890-199806150-00021

关键词: MedicineInternal medicineDiabetes mellitusTransplantationInsulinGastroenterologyC-peptidePancreatic diseasePancreasType 1 diabetesEndocrinologyBeta cell

摘要: Background. Pancreas transplants are rarely done in type 2 (noninsulin dependent) diabetic patients. Most researchers believe that patients, peripheral insulin resistance plays a central role and also is associated with relative deficiency or an secretory defect. This suggests patients receiving transplants, the new beta cells will be overstimulated, leading to cell exhaustion graft failure. Methods. Early our experience, simultaneous pancreas-kidney transplant candidates were selected using only clinical criteria for 1 diabetes, i.e., early onset of diabetes rapid use. Pretransplant sera available C-peptide analysis 70 94 those Forty-four percent (31/70) African American (AA). Results. Thirteen (12 AA) nonfasting level >1.37 ng/ml identified. In these high levels, pancreas kidney survival rates 100%. The results did not differ statistically from low group (≤1.37 ng/ ml). There no differences between patient when separated into AA non-AA groups. follow-up was 1-89 months, mean 45.5 months. Conclusions. Long-term function attainable does occur preoperative (>1.37 ml) levels. have equivalent long-term patient, kidney, rates.

参考文章(8)
L Papoz, T Marwah, D Cordonnier, D Zmirou, S Halimi, F Balducci, F Borgel, P Y Benhamou, Classification of Diabetes in Patients With End-Stage Renal Disease. Validation of Clinical Criteria According to Fasting Plasma C-peptide Clinical Nephrology. ,vol. 38, pp. 239- 244 ,(1992)
JOHN L. SMITH, LAWRENCE G. HUNSICKER, WILLIAM T. c. YUH, FRANCIS H. WRIGHT, LAURA VAN VOORHIS, ROBERT J. CORRY, Appearance of type II diabetes mellitus in type I diabetic recipients of pancreas allografts Transplantation. ,vol. 47, pp. 304- 311 ,(1989) , 10.1097/00007890-198902000-00023
Camillo Ricordi, Rodolfo Alejandro, M. Clara Angelico, Luis A. Fernandez, Jose Nery, Mark Webb, Rita Bottino, Gennaro Selvaggi, Farrukh A. Khan, Theodore Karatzas, Les Olson, Daniel H. Mintz, Andreas G. Tzakis, Human islet allografts in patients with type 2 diabetes undergoing liver transplantation Transplantation. ,vol. 63, pp. 473- 475 ,(1997) , 10.1097/00007890-199702150-00025
W. T. Garvey, J. M. Olefsky, A. H. Rubenstein, O. G. Kolterman, Day-Long Integrated Serum Insulin and C-Peptide Profiles in Patients With NIDDM: Correlation With Urinary C-Peptide Excretion Diabetes. ,vol. 37, pp. 590- 599 ,(1988) , 10.2337/DIAB.37.5.590
O. K. Faber, H. Kehlet, S. Madsbad, C. Binder, Kinetics of human C-peptide in man. Diabetes. ,vol. 27, pp. 207- 209 ,(1978) , 10.2337/DIAB.27.1.S207
S. Madsbad, O. K. Faber, C. Binder, P. McNair, C. Christiansen, I. Transbol, Prevalence of Residual Beta-cell Function in Insulin-Dependent Diabetics in Relation to Age at Onset and Duration of Diabetes Diabetes. ,vol. 27, pp. 262- 264 ,(1978) , 10.2337/DIAB.27.1.S262