Pulmonary function in patients with type 1 diabetes before and after simultaneous pancreas and kidney transplantation

Transplantation. 2007 Mar 15;83(5):566-9. doi: 10.1097/01.tp.0000253882.95177.61.

Abstract

Introduction: Pulmonary function is impaired in type 1 diabetes mellitus and is associated with the quality of metabolic control. Correction of chronic hyperglycemia by pancreas transplantation may ameliorate pulmonary function.

Methods: Lung volume and diffusing capacity were measured in 75 uremic patients with type 1 diabetes and a long diabetes duration waiting for a simultaneous kidney and pancreas transplantation (SPK). In addition 85 patients after SPK and 20 patients after kidney transplantation alone (KA) were investigated. In a subgroup of 30 patients, data before and after SPK were available for prospective analysis.

Results: Reduced lung volume and diffusing capacity were found in type 1 diabetic patients before transplantation. Nearly all parameters of pulmonary function improved after SPK and KA. A significant change was found for forced expiratory volume at 1 sec (FEV1) and FEV1/forced vital capacity (FVC) (Tiffenau index). A significant amelioration of diffusing capacity was only found in the SPK group but not in the KA group. The prospective investigation revealed significant improvements of pulmonary function after SPK: FEV1 (P=0.001), FVC, (P=0,006), Tiffenau index (P=0.03), and Hb-corrected diffusing capacity (carbon monoxide transfer factor, TCO), P=0.03; transfer coefficient (KCO=TCO corrected for alveolar volume), P=0.01.

Conclusion: Simultaneous pancreas and kidney transplantation is able to attain long-term normoglycemia and to improve pulmonary function in uremic type 1 diabetic patients.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 1 / surgery*
  • Diabetic Nephropathies / physiopathology
  • Diabetic Nephropathies / surgery*
  • Female
  • Forced Expiratory Volume
  • Glycated Hemoglobin A / analysis
  • Humans
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / physiology*
  • Male
  • Middle Aged
  • Pancreas Transplantation / physiology*
  • Postoperative Period
  • Preoperative Care
  • Reference Values
  • Respiratory Function Tests*
  • Vital Capacity
  • Waiting Lists

Substances

  • Glycated Hemoglobin A