Pancreas transplant for diabetes improves kidneys

People with Type 1 Diabetes often develop kidney failure and, when it's available, a combined kidney and pancreas transplant offers the prospect of curing both problems.

Now Italian researchers report that a pancreas transplant alone has a lasting beneficial effect on kidney impairment related to Diabetes.

Dr. Piero Marchetti of the University of Pisa and colleagues note that pancreas transplantation greatly helps people with diabetes by restoring insulin production, but the long-term effects on diabetes-related complications such as kidney impairment are not well defined.

To investigate, the researchers evaluated 32 type 1 diabetic patients before and a year after successful pancreas transplantation. Thirty matched "control" patients who did not undergo transplantation were also evaluated.

The transplant restored normal blood sugar levels without the need for insulin injections, Marchetti's group reports in the medical journal Diabetes Care. It also reduced cholesterol levels and significantly decreased blood pressure levels.

Furthermore, there was a significant decrease in urinary protein excretion, a sign of kidney damage.

No such changes were seen in patients who did not undergo transplantation.

The researchers call for longer-term studies, but add, "The beneficial effects of pancreas transplantation...on the native kidneys of diabetic patients supports the concept of considering pancreas transplantation alone as a useful therapeutic option."

Marchetti told Reuters Health that the 32 transplant patients were part of a group of 60 patients who have now undergone pancreas transplants. At four years, 98 percent of this group has survived and more than 80 percent no longer require insulin injections.

The procedure, he concluded, has led to "very positive results."

Diabetes Care, June 2005.