Improvements in diabetic microangiopathy after successful simultaneous pancreas-kidney transplantation: A computer-assisted intravital microscopy study on the conjunctival microcirculation
Atw. Cheung et al., Improvements in diabetic microangiopathy after successful simultaneous pancreas-kidney transplantation: A computer-assisted intravital microscopy study on the conjunctival microcirculation, TRANSPLANT, 68(7), 1999, pp. 927-932
A computer-assisted intravital microscopy technology has been developed to
noninvasively and objectively study diabetic microangiopathy in the conjunc
tival microcirculation of type-1 diabetics. Quantitative characterization o
f the conjunctival microcirculation was performed on 12 patients pre- and 1
8 months postsimultaneous pancreas kidney transplantation (SPK). Healthy no
ndiabetic volunteers (n=12), solitary kidney (K) transplanted type-1 diabet
ics (n=5), and nontransplanted type-1 diabetics (n=12) served as controls.
Pre-SPK diabetics showed abnormal-sized venules (diameter=66+/-7 mu m) and
reduced presence of arterioles (arteriole length/area=18+/-6 mu m(-1)) comp
ared with nondiabetic controls (53+/-4 mu m; 31+/-8 mu m(-1); P<0.05). The
computed vascular perfusion capacity of the conjunctival microvasculature w
as diminished in the same patients (pre-SPK diabetics=49+/-9%; nondiabetic
healthy controls=71+/-6%; P<0.05), Significant improvement in microangiopat
hy was observed in all post-SPK diabetics (diameter=58+/-6 mu m; arteriole
length/areaa=26+/-9 mu m(-1); vascular perfusion=63+/-8%; P<0.05) 18 months
post-SPK. Blood flow velocities in the conjunctival microcirculation in th
e same post-SPK patients showed noticeable but not significant improvements
(nondiabetic controls=2.94+/-0.57 mm/sec; pre-SPK=1.23+/-0.49 mm/sec; post
-SPK=1.65+/-0.42 mm/sec). The solitary kidney transplant controls (post-K)
showed no significant improvements in diabetic microangiopathy, confirming
the unique role of the pancreas in SPK. in general, significant improvement
s (P<0.05) in diabetic microangiopathy were observed in all 12 diabetics 18
months post-SPK but not in the controls.