Table 8:
Islet Transplantation and Secondary Complications of Diabetes for Patients with Type 1 Diabetes Mellitus, from Observational Case Series Studies
| Author, Year | Secondary Complications of Diabetes |
|---|---|
| Non-uremic patients | |
| Ryan et al, 2005 (9) |
Retinopathy: Deterioration of retinopathy in 4/47 patients (9%) Neuropathy: No change in peripheral neuropathy |
| Lee et al, 2005 (66) |
Retinopathy: No progression when compared with pre-transplantation measures in all 8 patients, improvement in 1 patient No significant correlation between changes in HbA1c values and retinopathic changes Neuropathy: Improvement or stabilization of diabetic neuropathy in 50% of 8 patients |
| Maffi et al, 2007 (57) |
Nephropathy: 17/19 patients (89%) normal creatinine, creatinine clearance, and urinary protein excretion pre- and post-transplantation 2/19 patients (11%) progressed to end-stage renal disease |
| Danielson et al, 2013 (70) |
Cardiovascular: Decrease in common carotid intima-media thickness at 12 mo (P = .006) NS changes in internal carotid artery thickness at 12 or 50 mo NS changes in systolic or diastolic blood pressure, triglycerides, and total cholesterol Nephropathy: NS changes in urine albumin-to-creatinine ratio or eGFR |
| O'Connell et al, 2013 (74) |
Nephropathy: Mean eGFR 77 ± 21 mL/min pre- vs. 67 ± 18 mL/min at 12 mo post-transplantation (P = .051) Mean creatinine 75 ± 11 µmol/L pre- vs. 86 ± 16 µmol/L at 12 mo post-transplantation (P < .05) |
| Uremic patients | |
| Borot et al, 2011 (63) |
Nephropathy: NS changes in creatinine and creatinine clearance pre- vs. post-transplantation |
| Fiorina et al, 2003 (58) |
Cardiovascular: Lower systolic blood pressure in successful islet transplantation group at 4 y (P = .01) NS differences in diastolic blood pressure between groups |
| Fiorina et al, 2003 (76) |
Cardiovascular: Higher cardiovascular death rate in unsuccessful IAK (4/13 pts) vs. successful IAK (1/21 pts) (P = .04) Lower intima-media thickness in unsuccessful IAK vs. successful IAK (P = .03) NS changes in arterial blood pressure Nephropathy: NS changes in creatinine levels during follow-up |
Abbreviation: eGFR, estimated glomerular filtration rate; HbA1c, glycosylated hemoglobin; IAK, islet-after-kidney transplantation; NS, non-significant.
Source: Adapted from Institute of Health Economics, 2013. (41)