Summary
We have evaluated the effect of successful pancreatic and kidney transplantation on autonomic neuropathy in nine Type 1 (insulin-dependent) diabetic subjects. Cardiovascular reflex tests were performed before and at 6–24 months after transplantation. A control group of ten Type 1 diabetic patients after kidney grafting only was examined at the same time periods. For base-line comparisons results of the tests in ten healthy subjects were used. Advanced autonomic neuropathy was present in both groups of transplant recipients and no significant changes in test results could be found at post-transplant evaluation. Lack of autonomic nerve function improvement was confirmed in seven patients of the pancreatic and kidney transplantation group who were examined again after 2–4 years. Irreversible structural autonomic nerve damage is probably present in uraemic pancreatic transplantation candidates.
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References
Bilous RW (1990) Diabetic autonomic neuropathy. A common complication which rarely causes symptoms. Br Med J 301:565–567
Ewing DJ, Martyn CN, Young RJ, Clarke BF (1985) The value of cardiovascular autonomic function tests: 10 years experience in diabetes. Diabetes Care 8:491–498
Heidbreder E, Schafferhans K, Heidland A (1985) Autonomic neuropathy in chronic renal insufficiency. Comparative analysis of diabetic and nondiabetic patients. Nephron 41:50–56
Kennedy WR, Navarro X, Goetz FC, Sutherland DER, Najarian JS (1990) Effects of pancreatic transplantation on diabetic neuropathy. N Engl J Med 322:1031–1037
Navarro X, Kennedy WR, Loewenson RB, Sutherland DER (1990) Influence of pancreas transplantation on cardiovascular relexes, nerve conduction, and mortality in diabetes mellitus. Diabetes 39:802–806
Nusser J, Kehrle M, Scheuer R, Illner W, Abendroth D, Land W, Landgraf R (1990) Follow-up of autonomic neuropathy after pancreas and/or kidney transplantation. Diabetologia 33(Suppl.):34 (Abstract)
Schafferhans K, Heidbreder E, Land W, Walter U, Stürmer W, Götz R, Heidland A (1986) Diabetic autonomic neuropathy after simultaneous transplantation: progressively across the Rubicon? Transplant Proc 18:1136–1138
Solders G, Gunnarsson R, Persson A, Wilczek H, Tydén G, Groth C-G (1987) Effects of combined pancreatic and renal transplantation on diabetic neuropathy: a two-year follow-up study. Lancet 2:1232–1235
Sundkvist G, Lilja B (1985) Autonomic neuropathy in diabetes mellitus: a follow-up study. Diabetes Care 8:129–133
Watkins PJ (1990) Diabetic autonomic neuropathy. N Engl J Med 322:1078–1079
Wieling W, van Brederode JEM, de Rijk LG, Borst C, Dunning AJ (1982) Reflex control of heart rate in normal subjects in relation to age: a data base for cardiac vagal neuropathy. Diabetologia 22:163–166
Zander E, Schulz B, Heinke P, Grimmberger E, Zander G, Gottschling HD (1989) Importance of cardiovascular autonomic dysfunction in IDDM subjects with diabetic nephropathy. Diabetes Care 12:259–264
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Bouček, P., Bartoš, V., Vaněk, I. et al. Diabetic autonomic neuropathy after pancreas and kidney transplantation. Diabetologia 34 (Suppl 1), S121–S124 (1991). https://doi.org/10.1007/BF00587636
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DOI: https://doi.org/10.1007/BF00587636