Evaluation of type 1 diabetics for simultaneous pancreas-kidney transplantation with regard to cardiovascular risk

Transplantation Proceedings
G WoesteW O Bechstein

Abstract

The main cause of death for diabetic patients and patients on dialysis is coronary artery disease (CAD). The most common cause of graft loss following simultaneous pancreas and kidney transplantation (SPK) is death with a functioning graft due to CAD. Therefore, careful pretransplantation evaluation of CAD is mandatory. In our series, every patient undergoes a noninvasive cardiac function test like dobutamine stress echocardiography (DSE) or myocardial thallium scintigraphy using adenosine to induce medical stress. Thirty patients were evaluated for SPK: 15 patients with myocardial scintigraphy and 8 with DSE. Seven investigations showed pathological findings and we performed coronary angiograms, none of which showed coronary artery stenosis. Seven primary coronary angiograms were performed: four due to a history of CAD and three as a primary diagnostic. Following SPK one patient died at 21 days after transplantation due to myocardial infarction. He had a history of CAD with angioplasty and stent implantation. Noninvasive cardiac function tests like DSE or myocardial scintigraphy are reliable methods to evaluate CAD in patients with diabetic nephropathy awaiting SPK. In case of a suspicious finding or a history of CAD, a corona...Continue Reading

References

Nov 1, 1993·American Journal of Hypertension·C L Manske
Jun 1, 1997·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·M KochB Grabensee
Jul 1, 1994·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·S A Abraham, K A Eagle
Oct 29, 2000·Transplant International : Official Journal of the European Society for Organ Transplantation·D FusterA Muxí
Dec 9, 2000·Transplant International : Official Journal of the European Society for Organ Transplantation·J C WestR Latsha
Dec 4, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Rainer W G GruessnerAngelika C Gruessner

❮ Previous
Next ❯

Citations

May 18, 2011·Journal of Intensive Care Medicine·Joseph R Scalea, Matthew Cooper

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.