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Long-term diabetes complications after pancreas transplantation

Jenssen, Tronda,c; Hartmann, Andersa,b; Birkeland, Kåre I.a,b

Current Opinion in Organ Transplantation: August 2017 - Volume 22 - Issue 4 - p 382–388
doi: 10.1097/MOT.0000000000000436
PANCREAS TRANSPLANTATION: Edited by Andrew L. Singer
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Purpose of review The intention of this study is to summarize present knowledge about adverse effects of hyperglycemia in diabetes, and in this context review more recent data concerning the effects of pancreas transplantation on a wide range of diabetic complications.

Recent findings Effective blood glucose control by insulin delays progression of microvascular complications and probably improves survival in type 1 diabetes. A successful pancreas transplantation combined with a kidney graft has recently been found to prevent diabetic kidney lesions, and registry data support improved long-term patient survival. Cardiovascular mortality was reduced in one study, even though coronary heart disease was not significantly altered. Advanced coronary lesions may be too advanced in these patients at baseline. However, with a successful single pancreas transplant, which is generally performed in patients with near-normal kidney function, pancreas transplantation may improve left ventricular function. Development of retinopathy and neuropathy is delayed with functioning pancreas grafts, and both quality of life and certain skin lesions may improve after pancreas transplantation.

Summary In patients with type 1 diabetes, pancreas transplantation may improve cardiac outcomes and ameliorate diabetic lesions in the kidney transplant. Also quality of life, neuropathy, retinopathy, and healing of certain skin lesions may be improved.

aDepartment of Transplantation Medicine, Oslo University Hospital, Rikshospitalet

bInstitute of Clinical Medicine, University of Oslo, Oslo

cMetabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway

Correspondence to Anders Hartmann, MD, PhD, Department of Transplantation Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen NO 0424 Oslo, Norway. E-mail: ahartman@ous-hf.no

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