Improvement in Autonomic and Gastric Function Following Pancreas-Kidney Versus Kidney-Alone Transplantation and the Correlation With Quality of Life1,2

Hathaway, Donna; Abell, Thomas L.; Cardoso, Sílvia Almeida; Hartwig, Mary S.; Gebely, Soliman E.L.; Gaber, A. Osama

doi:10.1097/00007890-199403270-00008

Cited by 147 publications

(62 citation statements)

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“…Conflicting results have been reported from renal and pancreatic-transplanted diabetic patients [21][22][23][24], however, improvement has been found after a follow-up period of 4ϩ years [22,23] therefore the follow-up of 17 months in the present investigation may be too short.…”

Section: Discussionmentioning

confidence: 62%

Impact of liver transplantation on autonomic neuropathy in familial amyloidotic polyneuropathy: an evaluation by spectral analysis of heart rate variability

Suhr

Wiklund

Ando³

et al. 1997

Journal of Internal Medicine

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Abstract. Suhr OB, Wiklund U, Ando Y, Ando E & Olofsson B-O (Umeå University Hospital, Umeå, Sweden). Impact of liver transplantation on autonomic neuropathy in familial amyloidotic polyneuropathy: an evaluation by spectral analysis of heart rate variability. J Intern Med 1997; 242: 225-9.Objectives. To evaluate the impact of liver transplantation on familial amyloidotic polyneuropathy type I (FAP) patients' autonomic neuropathy.Design. An open study. Setting. A tertiary referral centre. Subjects. Twelve liver-transplanted FAP patients evaluated before and one year or longer after liver transplantation.Interventions. Spectral analysis of heart rate variability. The low-frequency band after tilting (sympathetic), and the high-frequency band in supine position (parasympathetic) were analysed, as were the pulse and blood pressure reaction to tilting. Clinical symptoms related to autonomic disturbances were recorded. Main outcome measures. Spectral band power for sympathetic and parasympathetic activity. Results.No statistically significant improvements in sympathetic or parasympathetic band power after liver transplantation was found (sympathetic band power: 2.7 (2.2-3.2) before, 2.9 (2.2-3.6) after; parasympathetic 2.0 (1.6-2.4) before and 2.0 (1.7-2.3) after. A significant correlation was noted between orthostatic blood pressure reaction and sympathetic activity before transplantation, but not after the operation. A trend was noted for improved orthostatic blood pressure reaction. Symptomatic improvements in bowel function and orthostatic symptoms were reported by several patients. Conclusions. Although improvements in autonomic symptoms are reported after liver transplantation, no significant improvement is noted in sympathetic or parasympathetic spectral band power of heart rate variability. However, the follow-up period of 17 months may be too short. Further evaluation after an additional two and four years is needed.

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Section: Discussionmentioning

confidence: 62%

Impact of liver transplantation on autonomic neuropathy in familial amyloidotic polyneuropathy: an evaluation by spectral analysis of heart rate variability

Suhr

Wiklund

Ando³

et al. 1997

Journal of Internal Medicine

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“…Successsful pancreatic and kidney transplantation with subsequent near-normal longterm metabolic control did not improve heart rate variation at rest 2 to 3 years after transplantation [155]. Heart rate variation during deep breathing has been reported to remain unchanged in pancreas transplant recipients, whereas a tendency towards improved Valsalva ratio was noted [156].…”

Section: Secondary Prevention Of Cardiac Dysfunctionmentioning

confidence: 92%

A new look at the heart in diabetes mellitus: from ailing to failing

Standl

Schnell

2000

Diabetologia

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“…The procedure has become increasingly popular and successful in recent years owing to advances in surgical technique, and perhaps more importantly as a result of improvements in immunosuppressive therapy. There is an expanding volume of literature providing strong evidence for a salutary effect of pancreas transplantation on quality of life and on many of the secondary complications of type 1 diabetes, including reversal or stabilization of proliferative retinopathy, neuropathy, nephropathy, and gastroparesis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Recent studies even point toward stabilization or regression of coronary artery disease and decreased mortality in SPK recipients (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Effect of Ethnicity on Outcome of Simultaneous Pancreas and Kidney Transplantation

Rogers

Baliga

Chavin

et al. 2003

American Journal of Transplantation

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The influence of ethnicity on outcome of simultaneous pancreas-kidney transplantation (SPK) is poorly defined. After excluding technical failures, we retrospectively reviewed 96 consecutive SPKs (63 Caucasians [C], 33 African-Americans [AA]). All patients received antibody induction, tacrolimus, mycophenolate mofetil, and steroids. One-, 3-, and 5-year actuarial patient survival was similar between C (98%, 95%, 87%) and AA (90%, 90%, 81%), p = = NS. One-, 3-, and 5-year kidney graft survival was similar between C (98%, 86%, 81%) and AA (85%, 85%, 78%), p = = NS. One-, 3-, and 5-year pancreas graft survival was significantly worse in AA (71%, 68%, 46%) than in C (90%, 85%, 81%), p = = 0.008. The cumulative incidence of kidney and pancreas acute rejection (AR) was higher in AA compared with C. Distribution of kidney and pancreas rejection grade was similar between C and AA. AA experienced more pancreas graft losses from early death with functioning graft, AR, and late chronic rejection. The higher incidence of AR and resistance to currently employed induction, maintenance, and antirejection immunosuppression therapies in AA may account for their inferior pancreas graft survival. More aggressive immunosuppression strategies may improve pancreas graft survival in AA but may be associated with increased morbidity and mortality. Further study is warranted.

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Improvement in Autonomic and Gastric Function Following Pancreas-Kidney Versus Kidney-Alone Transplantation and the Correlation With Quality of Life1,2

Cited by 147 publications

References 0 publications

Impact of liver transplantation on autonomic neuropathy in familial amyloidotic polyneuropathy: an evaluation by spectral analysis of heart rate variability

Impact of liver transplantation on autonomic neuropathy in familial amyloidotic polyneuropathy: an evaluation by spectral analysis of heart rate variability

A new look at the heart in diabetes mellitus: from ailing to failing

Effect of Ethnicity on Outcome of Simultaneous Pancreas and Kidney Transplantation

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