Massimo Venturini, Presenter: Nothing to Disclose

Paolo Fiorina, Abstract Co-Author: Nothing to Disclose

Claudio Losio, Abstract Co-Author: Nothing to Disclose

Paola Maffi, Abstract Co-Author: Nothing to Disclose

Antonio Secchi, Abstract Co-Author: Nothing to Disclose

Alessandro Del Maschio MD, Abstract Co-Author: Nothing to Disclose

Atherothrombotic complications are the main cause of death in type I diabetes. Pancreas and pancreatic islets transplant determine diabetes resolution. Our aim was to evaluate with CDU and clinical markers the effects of pancreas and pancreatic islets transplant on intima media thickness (IMT), endothelial dependent dilation (EDD) and atherothrombotic risk factors in 124 type I diabetic uremic kidney-transplanted patients.

60 kidney-pancreas (KP) compared to 30 kidney-alone (KA) and 21 successful-kidney-islets (KI-s) compared to 13 unsuccessful-kidney-islets (KI-u) transplanted patients were cross-sectionally studied in a 4 years follow-up: CDU (Philips-ATL/HDI5000, 5-12 MHz linear array) of common carotid artery IMT (distance between the lumen-intima and the media-adventitia interfaces) and of right brachial artery EDD (% increase in anteroposterior diameter after locally induced hyperemia), and atherothrombotic risk factors (glycated hemoglobin, C-peptide, vWF and D-dimer fragments) were assessed.

At 4 years IMT was lower in KP than KA groups (0.74±0.03mm vs 0.86±0.09mm,p=0.04), with IMT stabilization in KI-s(Δ=-13±30μm)and increase in KI-u(Δ=245±20μm,p=0.03). EDD in KP was normal and higher than in KA(6.2±1.3% vs 0.6±1%,p<0.01);KI-s showed a higher EDD than KI-u(7.8±4.5% vs 0.5±2.7%,p=0.02).Glycated hemoglobin was lower in KP than KA(6.2±0.1% vs 8.4±0.5%,p<0.01)and comparable in KI-s to KI-u.C-peptide was higher in KP than KA(1.43±0.08ng/ml vs 0.02±0.01ng/ml,p<0.01)and in KI-s than KI-u(1.09±0.16ng/ml vs 0.14±0.02ng/ml,p<0.01).VWF and D-dimer fragments levels were lower in KP than KA(vWF=157.9±8.6% vs 212.5±16.2%;DDF=0.29±0.02μg/ml vs 0.73±0.11μg/ml,p<0.01) and in KI-s than KI-u(vWF=138.6±15.3% vs 180.6±7.0%,p=0.02;DDF=0.61±0.22μg/ml vs 3.07±0.68μg/ml,p<0.01).

In type I diabetic uremic patients, Kidney-pancreas and successful-kidney-islets transplantation improve glycomethabolic profile, reduce thrombotic status, normalize endothelial function and IMT, exerting a protection on cardiovascular complications.

Venturini, M, Fiorina, P, Losio, C, Maffi, P, Secchi, A, Del Maschio, A, Color Doppler Ultrasound (CDU) and Clinical Assessment of Intima Media Thickness, Endothelial Function and Atherothrombotic Risk Factors in 124 Type I Diabetic Uremic Patients after Kidney-Pancreas and Successful-Kidney-Islets Transplantation.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4420260.html