Massimo Venturini MD, Presenter: Nothing to Disclose

Claudio Losio MD, Abstract Co-Author: Nothing to Disclose

Mauro Padrenostro, 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 long-term type I diabetic uremic kidney transplanted patients, pancreas or pancreatic islets transplantation can determine diabetes resolution. IA transplantation has been recently introduced for diabetic non uremic patients to prevent diabetes-related complications such as retinopathy, characterized by endothelial dysfunction conditioning a reduction of CRA flow velocities. Our aim was to compare CRA flow velocities changes in KP, KA and IA patients after transplant.

CRA of 10 KP, 10 KA and 10 IA transplanted patients were evaluated with CDU (ATL-HDI5000, 5-12 MHz linear probe) by the same operator before and 2 years after transplantation. Peak systolic (psv) and end diastolic (edv) velocities were measured for each central retinal artery at the retrobulbar level, and expressed as the mean of both eyes.

All groups showed similar arterial retinal blood flow velocities at baseline. At 2 years the KP and KA groups didn’t show a significant increase of arterial retinal blood flow velocities (KP-psv: 5.73±1.75 vs 6.06±1.44; KP-edv: 1.68±0.31 vs 2.0±0.44; KA-psv: 4.55±1.42 vs 5.74± 2.06; KA-edv: 1.68±0.54 vs 1.57±0.39, P=n.s.). A statistically significant increase in central retinal artery velocities was found only in IA patients, with significantly higher values than KP and KA (IA-psv: 10.12±1.20 vs 6.09±0.46, p<0.01; IA-edv: 2.99±0.48 vs 1.65± 0.07, P=0.02).

CDU allows quantitative and reproducible measurements of CRA blood flow velocities. A significant improvement of CRA flow velocities was evident only in IA transplanted patients, and not in KP patients, despite diabetes resolution in both groups: probably a reversal of endothelial dysfunction in retinal microcirculation is less likely in patients affected by a longer duration of diabetes, with related uremia and microvascular complications.

CDU can accurately and non invasively study retinal microcirculation. An improvement of CRA flow velocities can be obtained only in non uremic, diabetic patients after IA transplantation.

Venturini, M, Losio, C, Padrenostro, M, Maffi, P, Secchi, A, Del Maschio, A, Color Doppler Ultrasound (CDU) Assessment of Blood Flow Velocities Changes in Central Retinal Artery (CRA) of Kidney-Pancreas (KP), Kidney Alone (KA) and Islet Alone (IA) Transplanted Type I Diabetic Patients.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5010891.html