P. Voros et al., ALBUMINURIA AFTER FETAL PANCREATIC-ISLET TRANSPLANTATION - A 10-YEAR FOLLOW-UP, Nephrology, dialysis, transplantation, 13(11), 1998, pp. 2899-2904
Aim of the study, The prevention of diabetic nephropathy is as yet an
unresolved issue. The aim of our study was to assess the effects of tr
ansplantation of long-term cultured and cryopreserved fetal pancreas i
slets on metabolic control and the development of diabetic nephropathy
. Methods. Serum C-peptide, glucose, HbA(1c), insulin requirements, ur
inary albumin excretion rate, and blood pressure of 10 insulin-depende
nt diabetic patients after transplantation were compared with a group
of 27 insulin-dependent diabetic controls on insulin therapy only duri
ng a 10-year follow-up. Results. In the first year after transplantati
on mean insulin requirement decreased from 53.6 +/- 2.2 to 35.8 +/- 1.
2 units. C-peptide levels appeared (0.55 +/- 0.08 ng/ml) and remained
detectable throughout the follow-up. Blood glucose and HbA(1c) were si
gnificantly (P < 0.05) lower than in the controls. Mean albumin excret
ion rates of the transplant and the control groups during the follow u
p were 18.8 +/- 8.5 and 11.7 +/- 2.0, 16.6 +/- 6.6 and 14.0 +/- 2.3, 1
5.0 +/- 5.0 and 15.1 +/- 2.7, 15.3 +/- 7.5 and 20.4 +/- 4.2, 19.8 +/-
6,2 and 36.7 +/- 11.1, 11.7 +/- 3.6 and 51.3 +/- 14.6, 14.1 +/- 4.2 an
d 71.4 +/- 23.1, 22.7 +/- 8.6 and 92.0 +/- 28.1, 18.0 +/- 5.9 and 107.
6 +/- 35.6, 21.7 +/- 11.0 and 101.5 +/- 29.3 mu g/min respectively. Fr
om the 6th year the difference between the two groups was significant
(P < 0.001). In the transplant group initial mean systolic and diastol
ic blood pressure values were 132.0 +/- 3.3 and 81.5 +/- 1.5 mmHg, in
the controls 130.4 +/- 3.4 and 79.6 +/- 1.6 mmHg respectively. Signifi
cant changes (P < 0.05) of blood pressure during the follow-up or diff
erences between the two groups were not observed. Conclusions. We conc
lude that fetal islet transplantation is effective in achieving good l
ong-term diabetes control and in the prevention of diabetic nephropath
y.