Pulmonary Function in Patients With Type 1 Diabetes Before and After Simultaneous Pancreas and Kidney Transplantation

Abstract

Introduction. Pulmonary function is impaired in type 1 diabetes mellitus and is associated with the quality of metabolic control. Correction of chronic hyperglycemia by pancreas transplantation may ameliorate pulmonary function. Methods. Lung volume and diffusing capacity were measured in 75 uremic patients with type 1 diabetes and a long diabetes duration waiting for a simultaneous kidney and pancreas transplantation (SPK). In addition 85 patients after SPK and 20 patients after kidney transplantation alone (KA) were investigated. In a subgroup of 30 patients, data before and after SPK were available for prospective analysis. Results. Reduced lung volume and diffusing capacity were found in type 1 diabetic patients before transplantation. Nearly all parameters of pulmonary function improved after SPK and KA. A significant change was found for forced expiratory volume at 1 sec (FEV 1 ) and FEV 1 /forced vital capacity (FVC) (Tiffenau index). A significant amelioration of diffusing capacity was only found in the SPK group but not in the KA group. The prospective investigation revealed significant improvements of pulmonary function after SPK: FEV 1 (Pϭ0.001), FVC, (Pϭ0,006), Tiffenau index (Pϭ0.03), and Hb-corrected diffusing capacity (carbon monoxide transfer factor, T CO ), Pϭ0.03; transfer coefficient (K CO ϭT CO corrected for alveolar volume), Pϭ0.01. Conclusion. Simultaneous pancreas and kidney transplantation is able to attain long-term normoglycemia and to improve pulmonary function in uremic type 1 diabetic patients.

Pulmonary capillary permeability and pulmonary microangiopathy in diabetes mellitus

“…In patients with type 1 DM, a significant lung function improvement was observed after a pancreas transplant [14]. The mechanisms of the improvement by glucose normalization are unclear.…”

Gambaran Uji Fungsi Paru pada Diabetes Melitus Tipe 1 Usia 8-18 Tahun

“…Studi lain dari pasien DMT1 dengan uremik, mengalami peningkatan parameter spirometri dan difusi CO setelah transplantasi ginjal dan pankreas dibandingkan transplantasi ginjal saja. 46 Studi ini mendukung reversibilitas dari gangguan paru yang terjadi setelah kondisi normoglikemia tercapai.…”

Indikation und Ergebnisse der simultanen Nieren-Pankreas-Transplantation

“…Diese Erkenntnisse wur den in vielfältigen weiteren Untersuchun gen von anderen Autoren bestätigt [3,8,12,13,14,25].…”