TY - JOUR
T1 - A case control study of renal transplantation in patients with type I diabetes
AU - Munson, J. L.
AU - Bennett, W. M.
AU - Barry, J. M.
AU - Norman, D. J.
PY - 1992
Y1 - 1992
N2 - A case control study was undertaken comparing the outcome of 208 renal allografts transplanted into diabetic recipients with those transplanted into an appropriately matched group of non-diabetic recipients. In each group there were 151 cadaver, 21 two-haplotype identical, 35 one-haplotype identical, and one zero-haplotype identical living-related grafts. For the entire group of diabetics, 1- and 5-year graft survivals were 71.3% and 46%. Graft survivals for the non-diabetic recipients at 1 and 5 yr were 81.8% and 57.8%, (p < 0.05). In all patient subgroups divided according to the donor source, the graft and patient survival rates for the non-diabetic recipients exceeded those of the diabetic recipients. One- and 5-yr diabetic patient survivals were 90% and 70%, and for the non-diabetics they were 97% and 95%, respectively (p < 0.001). There were 40 deaths among the diabetics and 15 among the non-diabetics. Cardiovascular disease was the major cause of death in the diabetics, accounting for 40% of the deaths. In addition, allograft loss due to patient death was a significant cause of graft loss in the diabetic group, 24 grafts (28%). Seven grafts (10%) were lost due to patient death in the nondiabetic group (p < 0.05). Post-transplant, diabetic recipients had a greater incidence of stroke, angina, myocardial infarction, peripheral vascular disease, urinary tract infections (p < 0.01 for each), and wound infections (p < 0.05). Despite improvements in results with renal transplantation in diabetics, our study indicates that the results do not approach those of an appropriately matched group of non-diabetics. With their higher incidence of complications, the management of diabetics will continue to be a challenge.
AB - A case control study was undertaken comparing the outcome of 208 renal allografts transplanted into diabetic recipients with those transplanted into an appropriately matched group of non-diabetic recipients. In each group there were 151 cadaver, 21 two-haplotype identical, 35 one-haplotype identical, and one zero-haplotype identical living-related grafts. For the entire group of diabetics, 1- and 5-year graft survivals were 71.3% and 46%. Graft survivals for the non-diabetic recipients at 1 and 5 yr were 81.8% and 57.8%, (p < 0.05). In all patient subgroups divided according to the donor source, the graft and patient survival rates for the non-diabetic recipients exceeded those of the diabetic recipients. One- and 5-yr diabetic patient survivals were 90% and 70%, and for the non-diabetics they were 97% and 95%, respectively (p < 0.001). There were 40 deaths among the diabetics and 15 among the non-diabetics. Cardiovascular disease was the major cause of death in the diabetics, accounting for 40% of the deaths. In addition, allograft loss due to patient death was a significant cause of graft loss in the diabetic group, 24 grafts (28%). Seven grafts (10%) were lost due to patient death in the nondiabetic group (p < 0.05). Post-transplant, diabetic recipients had a greater incidence of stroke, angina, myocardial infarction, peripheral vascular disease, urinary tract infections (p < 0.01 for each), and wound infections (p < 0.05). Despite improvements in results with renal transplantation in diabetics, our study indicates that the results do not approach those of an appropriately matched group of non-diabetics. With their higher incidence of complications, the management of diabetics will continue to be a challenge.
KW - Diabetes
KW - Renal transplantation
UR - http://www.scopus.com/inward/record.url?scp=0026794622&partnerID=8YFLogxK
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M3 - Article
C2 - 10147945
AN - SCOPUS:0026794622
SN - 0902-0063
VL - 6
SP - 306
EP - 311
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 4
ER -