June 28, 2005

Pancreas transplant for diabetes improves kidneys

By David Douglas

NEW YORK (Reuters Health) - 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

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

Diabetes Care, June 2005.