Long-term follow-up of renal transplantation in type 1 and type 2 diabetic patients

Abstract

This study evaluated the long-term outcome of renal transplantation in type 1 (n = 25) and type 2 (n = 18) diabetic patients. Overall postoperative survival at 1 year was 69% in type 1 diabetes and 75% in type 2; at 5 years it was 62% in type 1 diabetes and 58% in type 2. Death was due mainly to cardiovascular disease (60%) and septic gangrene (20%). Outcome was examined in terms of graft function, which was poor in the majority (86%) of patients who died. Patients with fatal outcome suffered major vascular complications prior to renal transplantation and frequently had impaired graft function. Metabolic control was better in patients with good graft function (HbA1c < 6.2%) than in those with poor or no function of kidney transplant (HbA1c > 9.8%). In the absence of severe vascular complications renal transplantation may be the treatment of choice for both type 1 and type 2 diabetic patients with end-stage renal disease. Otherwise, renal transplantation is not able to improve the prognosis of patients with a history of severe vascular complications prior to renal replacement therapy.

Type II diabetes mellitus and chronic renal insufficiency: renal transplantation or haemodialysis treatment?

“…In the last decade, the number of diabetic patients with ESRD accepted for renal replacement therapy has increased continuously [5]. However, data concerning the prognosis of type II diabetic patients with chronic renal insufficiency are rare [6]. Nevertheless, type II diabetic patients are often not considered for renal transplantation.…”

“…The overall 1 and 5 year survival rates ranged from 58 and 14% respectively for all type 2 diabetic patients [5,6]. Survival was better in diabetic renal transplant recipients as compared with diabetic patients maintained on haemodialysis treatment (5 year survival: 59 versus 2%; P< 0.001).…”