Combined Pancreas‐Kidney Transplantation

Preliminary Results and Metabolic Effects

R. J. Stratta, R. J. Taylor, B. H. Zorn, C. Ozaki, Jennifer Lynn Larsen, W. C. Duckworth, Alan Norman Langnas, R. P. Wood, T. O. Wahl, W. C. Marujo, S. Li, B. W. Shaw

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Vascularized pancreas transplantation (PT) results in a self‐regulating endogenous source of insulin. In the last 18 months, we have performed combined pancreas‐kidney transplantation in 25 type I diabetics with nephropathy. The mean age of the recipient group was 35 yr (range 24–51) with a mean duration of diabetes of 22 yr (range 13–41). All patients received quadruple immunosuppression with OKT3 induction. All patients remained normoglycemic and insulin independent with a mean glycosylated hemoglobin level of 6.0 ± 1.1% and a mean serum creatinine of 1.7 ± 0.5 mg/dl. Metabolic control and hormonal profiles were assessed by intravenous glucose challenge followed by arginine stimulation. Metabolic effects of PT included fasting hyperinsulinemia and hyperglucagonemia with exaggerated insulin and glucagon responses to glucose and arginine, respectively. Patient and graft survival is 100% after a mean follow‐up interval of 8 months. Conclusion: combined pancreas‐kidney transplantation is a valid treatment option for diabetic nephropathy, and results in near‐complete normalization of glucose metabolism.

Original languageEnglish (US)
Pages (from-to)697-703
Number of pages7
JournalThe American journal of gastroenterology
Volume86
Issue number6
DOIs
StatePublished - Jan 1 1991

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Pancreas Transplantation
Transplantation
Diabetic Nephropathies
Insulin
Glucose
Arginine
Muromonab-CD3
Glycosylated Hemoglobin A
Hyperinsulinism
Graft Survival
Glucagon
Immunosuppression
Fasting
Creatinine
Age Groups
Serum
Therapeutics

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Combined Pancreas‐Kidney Transplantation : Preliminary Results and Metabolic Effects. / Stratta, R. J.; Taylor, R. J.; Zorn, B. H.; Ozaki, C.; Larsen, Jennifer Lynn; Duckworth, W. C.; Langnas, Alan Norman; Wood, R. P.; Wahl, T. O.; Marujo, W. C.; Li, S.; Shaw, B. W.

In: The American journal of gastroenterology, Vol. 86, No. 6, 01.01.1991, p. 697-703.

Research output: Contribution to journalArticle

Stratta, RJ, Taylor, RJ, Zorn, BH, Ozaki, C, Larsen, JL, Duckworth, WC, Langnas, AN, Wood, RP, Wahl, TO, Marujo, WC, Li, S & Shaw, BW 1991, 'Combined Pancreas‐Kidney Transplantation: Preliminary Results and Metabolic Effects', The American journal of gastroenterology, vol. 86, no. 6, pp. 697-703. https://doi.org/10.1111/j.1572-0241.1991.tb07114.x
Stratta, R. J. ; Taylor, R. J. ; Zorn, B. H. ; Ozaki, C. ; Larsen, Jennifer Lynn ; Duckworth, W. C. ; Langnas, Alan Norman ; Wood, R. P. ; Wahl, T. O. ; Marujo, W. C. ; Li, S. ; Shaw, B. W. / Combined Pancreas‐Kidney Transplantation : Preliminary Results and Metabolic Effects. In: The American journal of gastroenterology. 1991 ; Vol. 86, No. 6. pp. 697-703.
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