Claudio Losio, Presenter: Nothing to Disclose

Massimo Venturini MD, Abstract Co-Author: Nothing to Disclose

Paolo Fiorina, 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

In type I diabetic uremic kidney-transplanted patients, the persistence of diabetes and nephrotoxicity of immunosuppressive agents can reduce kidney-graft function. Simultaneous pancreas or successful-islets transplantation restore normoglycemia. Our aim was to retrospectively evaluate the transplanted kidneys of Kidney-Alone (KA), Kidney-Pancreas (KP) and Successful-Kidney-Islets (KIS) transplanted patients.

The transplanted kidneys of 168 KP, 28 KIS and 44 KA patients were evaluated with CDU: the mean resistance index (RI) of three intraparenchimal arteries and renal size (distance between the upper and lower poles) were measured. Urinary Albumin Excretion (UAE), Serum Creatinine (SC), Glycated Hemoglobin (HbA1c) at 2, 4, 6 years and kidney-graft cumulative survival were assessed. Random kidney biopsies for Nitric Oxide expression were also performed.

The KP and KIS groups only showed a significant reduction of RI (KP: 0.68±0.01 vs 0.74±0.01; KIS: 0.69±0.02 vs 0.72±0.02, p<0.05; KA: 0.76±0.04 vs 0.76±0.02). Despite all groups showed an increase in graft size after the transplant, only in the KP group renal hypertrophy persisted at 6 years from transplantation. An increase of UAE was evident only among KA patients (82.9±33.6 vs 31.4±9.0 mg/L). A significant increase in SC was found at 6 years only in KA group, not in KP and KIS (2.78±0.44 vs 1.58±0.08 mg/dl, p<0.05). HbA1c levels at 6 years were significantly lower in KP than KA (5.9±0.1% vs 8.1±0.4%, p<0.05). The KP and KIS groups had a better cumulative kidney graft survival at 6 years than the KA group (73%, 86%, 42%,p<0.01). Graft Nitric Oxide expression was higher in the KP/KIS than the KA groups.

CDU allows quantitative and reproducible measurements of transplanted kidney. Pancreas and successful-islets transplantation, restoring glycometabolic control, exert a protection on function, hypertrophy and microcirculation of the kidney-graft, improving its survival.

In type I diabetic uremic patients CDU can demonstrate the beneficial effects of pancreas and islets transplantation on the transplanted kidney, correlating with clinical markers.

Losio, C, Venturini, M, Fiorina, P, Maffi, P, Secchi, A, Del Maschio, A, Clinical and Color Doppler Ultrasound (CDU) Assessment of Transplanted Kidney in 240 Type I Diabetic Uremic Patients: Long Term Protective Role of Pancreas and Successful Islets Transplantation.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4441189.html