Pancreas/kidney-pancreas transplantation (tx) is a procedure still affected by major risk. Positive effects of this procedure on diabetic complications were shown. Here the authors will discuss the positive effects of combined kidney-pancreas (KP) tx on glucose metabolism, long-term diabetic complications, and survival. A reduction of diastolic dysfunction was observed 4 years after tx in the KP (pre-tx: 73%, post-tx: 26%) but not in the kidney-alone (KA) group (pre-tx: 88%, post-tx: 77%). Normal endothelial function and lower intima media thickness were evident in the KP group. Fifty-one percent only of the KP group remain hypertensive at 1 year after tx, versus 81% of the KA group. Finally, among uremic type 1 diabetic patients enrolled for transplantation, those who received KP, KA, or remained on dialysis showed an actuarial survival at 7 years of 76.2%, 63.5%, and 39.6%, respectively. In conclusion, the KP group showed a better survival and reduced complications than the KA group.
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