[The effect of pancreas and kidney transplantation on diabetic autonomic neuropathy].

The authors examined, using cardiovascular reflex tests, nine type I diabetics 6-48 months after combined transplantation of the pancreas and kidney with satisfactory function of both grafts. The control group was formed by 10 type 1 diabetics after transplantation of the kidney and 10 subjects free from disease causing damage to the vegetative nervous system. The results of the examination during the pretransplantation period suggested in both groups of diabetics severe affection of the vegetative nervous system. Despite long-term practical normalization of the diabetic metabolic disorder, in the patients after transplantation of the pancreas no detectable improvement of findings was recorded. Changes in the tests used were not found either in the control group of patients after isolated transplantation of the kidney. Damage of the vegetative nervous system in uraemic patients is probably irreversible and intervention studies are therefore indicated in an earlier stage of the disease.