Massimo Venturini MD, Presenter: Nothing to Disclose

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

Paolo Fiorina, Abstract Co-Author: Nothing to Disclose

Alessandra Petrelli, Abstract Co-Author: Nothing to Disclose

Paola Maffi, Abstract Co-Author: Nothing to Disclose

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

In type 1 diabetic patients, endothelial dysfunction is commonly present with consequent progressive increase of risk of cardiovascular diseases. A reversal of endothelial dysfunction was previously described after pancreas transplant. As alternative to pancreas surgical transplant, percutaneous intraportal islet transplant can be performed in long term diabetic, uremic patients after kidney transplant (IAK) or in non uremic patients (ITA). Our aim was to evaluate the endothelial function after ITA.

We studied with US (Philips-ATL IU-22) the right brachial arteries of 10 ITA patients with good islet function (C-peptide >1 ng/ml), 10 IAK patients, 10 type 1 diabetic untrasplanted patients (T1D) and 10 normal subjects as control (C). Mean diameter variation after local ischemia (brachial compression) and after nitrates (sublingual administration) was evaluated to assess endothelial dependent (EDD) and independent dilation (EID). As clinical parameters were evaluated glycated hemoglobin and, as atherothrombotic factor, homocysteinemia levels.

A statistically significant increase of EDD (P<0.001) was found in ITA patients (and C patients) if compared with IAK and T1D patients: variation of diameter after local ischemia was significantly higher in ITA (11.77±0.84%) and C (8.84±0.83%) patients than in T1D (2.58±0.85%) and in IAK (0.54±0.48%) patients. No statistically significant differences were found considering EID. Glycated hemoglobin levels were significantly higher in T1D and IAK (diabetic patients) than in ITA e C patients. Homocysteinemia levels were statistically lower (p<0.001) in ITA (11.99±1.13 μmol/l) than in IAK (18.53±0.65 μmol/l) patients.

Endothelial function can be easily and non invasively study by US. ITA can determine a reversal of endothelial dysfunction, probably exerting a protective role on diabetic cardiovascular complications.

Percutaneous intraportal transplant of pancreatic islet in diabetic non uremic patients determining a reversal of endothelial dysfunction can exert a protective role on cardiovacular complications.

Venturini, M, Losio, C, Fiorina, P, Petrelli, A, Maffi, P, Del Maschio, A, Reversal of Endothelial Dysfunction in Type 1 Diabetic Non-uremic Patients after Percutaneous Intraportal Pancreatic Islet Transplant Alone (ITA): US and Clinical Evaluation.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6022285.html