Diabetic microangiopathy in Type 1 (insulin-dependent) diabetic patients after successful pancreatic and kidney or solitary kidney transplantation

To evaluate the beneficial effect of pancreatic grafting on
peripheral microcirculation and long-term clinical outcome, we
compared data of 28 Type 1 (insulin-dependent) diabetic patients
either given a pancreatic and kidney graft simultaneously or given
a solitary kidney graft (n=17). Peripheral microcirculation was
estimated by transcutaneous oxygen pressure measurement (including
reoxygenation potential after blood flow occlusion) and erythrocyte
flow / velocity by a non-contact laser speckle method. All the
measured parameters showed significant differences between diabetic
and control subjects in the mean follow-up time of 49 (simultaneous
pancreas and kidney transplantation) and 43 (solitary kidney
transplantation) months. The data from patients after simultaneous
pancreas and kidney transplantation revealed an improvement of
transcutaneous oxygen pressure measurement (rise from 46±2 mm Hg to
63±3 mmHg), reoxygenation time (fall from 224±12s to 114±6s) and
laser speckle measurement (rise from 4.2±1.7 to 5.6±1.8 relative
units). The control group with solitary kidney transplantation did
not show a positive evaluation. Data from patients after
simultaneous pancreas and kidney transplantation revealed an
improvement in transcutaneous oxygen pressure measurement,
reoxygenation time and laser speckle measurement whereas the
control group with solitary kidney transplantation did not show a
positive evaluation. Improved microcirculation was more pronounced
in patients with better microvascular preconditions. The results
confirm that diabetic microangiopathy is positively influenced by
pancreatic transplantation.