Islet transplantation improves vascular diabetic complications in patients with diabetes who underwent kidney transplantation: a comparison between kidney-pancreas and kidney-alone transplantation

Transplantation. 2003 Apr 27;75(8):1296-301. doi: 10.1097/01.TP.0000061788.32639.D9.


Background: The aim of this study was to evaluate the effects of islet transplantation on patient survival and diabetic vascular complications.

Methods: Thirty-seven type 1 uremic diabetic kidney transplant patients underwent islet transplantation (KI group). Uremic type 1 diabetic kidney-pancreas (KP group, n=162), kidney-alone (KD group, n=42) transplant patients, and uremic type 1 diabetic patients still on hemodialysis (HD+DM group, n=196) constituted the control groups for survival and endothelial morphology.

Results: Patient survival was similar in the KI and KP groups and higher than in the HD+DM group (P<0.05). Patients experiencing long-term islet function (KI-successful [KI-s], n=24) showed a better survival (100%, 100%, and 90%) than those in the KI group who lost islet function (KI-unsuccessful [KI-u], n=13) (84%, 75%, and 45%) at 1, 4 and 7 years, respectively (P=0.02). The cardiovascular death rate for the KI group (18%) was similar to the KD group (19%) but lower when the KI-s group is considered alone (5%), and showed a cardiovascular death rate similar to the KP group (8%). The KI-s group showed a good metabolic profile, with reduction of exogenous insulin requirement and persistent C-peptide secretion, as compared with the KI-u group. The endothelial morphology was evaluated with a skin biopsy obtained in all groups. The KI-s and the KP groups demonstrated decreased signs of endothelial injury compared with the KI-u and HD+DM groups. The KI group showed a better atherothrombotic profile than the HD+DM group, with higher levels of natural anticoagulant protein.

Conclusions: Successful islet transplantation improves survival, atherothrombotic profile, and endothelial morphology in uremic type 1 diabetic kidney transplant patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antithrombin III / analysis
  • Arteriosclerosis / etiology
  • Biopsy
  • Cardiovascular Diseases / mortality
  • Diabetes Mellitus, Type 1*
  • Diabetic Angiopathies / surgery*
  • Humans
  • Islets of Langerhans Transplantation*
  • Kidney / physiopathology
  • Kidney Transplantation*
  • Middle Aged
  • Protein C / analysis
  • Risk Factors
  • Skin / pathology
  • Survival Analysis
  • Thrombosis / etiology


  • Protein C
  • Antithrombin III