EARLY IMPROVEMENT IN CARDIAC-FUNCTION OCCURS FOR PANCREAS-KIDNEY BUT NOT DIABETIC KIDNEY-ALONE TRANSPLANT RECIPIENTS

Noninvasive M mode echocardiography with Doppler recording was prospec tively performed on type I diabetic recipients of pancreas-kidney (n=2 0), pancreas-after-kidney (n=2), and kidney-alone (n=11) allografts to determine whether the return of euglycemia by pancreas transplantatio n in the uremic diabetic person was associated with improved cardiac f unction. Each patient was studied preoperatively and at 6 and 12 month s posttransplant. Echocardiographic parameters which were compared inc luded measures of systolic function (shortening fraction), diastolic f unction (early/active peak velocity ratio, early/active integral ratio ), and left ventricular geometric parameters (interventricular septal thickness, posterior wall thickness, left ventricular mass). The only statistically significant improvement observed for kidney-alone recipi ents was an increased shortening fraction from baseline (24.91%) to 6 months (32.13%, P less than or equal to 0.0188). In contrast, the panc reas group demonstrated sustained improvement in all outcomes with mea sures at 12 months consistently showing a significant improvement from baseline which was also significantly better than that reported for t he kidney-alone group. This study showed stabilization of cardiac func tion by echocardiography for diabetic kidney-alone recipients, whereas significant improvement in function occurred for pancreas-kidney reci pients. The improvement in cardiac function for pancreas recipients wa s seen at 6 months with continued improvement evident at 12 months.