Kumar S, Merchant M R, Dyer P, Martin S, Hutchison A J, Johnson R W, Boulton A J, Gokal R
Manchester Royal Infirmary, UK.
Diabet Med. 1994 Dec;11(10):987-91. doi: 10.1111/j.1464-5491.1994.tb00259.x.
The graft and patient survivals following renal transplantation in all Type 1 diabetic patients transplanted within the North-West of England between 1981 and 1990 at Manchester Royal Infirmary were studied. Fifty-two Type 1 (insulin-dependent) diabetic patients with end-stage renal failure due to diabetic nephropathy were transplanted during this period. They were compared to controls matched for age, sex, and year of transplantation and also to all 904 patients transplanted during the same period. Graft survival rates at 1 and 5 years in the diabetic patients were lower (80.8% and 62.1%, respectively), compared to controls (88.9% and 77.9%, respectively, p = 0.02) but were similar to those seen in all grafts (80.4% and 59.0%, respectively, p = NS). Actuarial patient survival rate at 5 years was lower in diabetic patients (76.3%) compared to the control group (94.2%, p = 0.003). Myocardial infarction was the main cause (60%) of death in diabetic patients. The results of this large recent series indicate that good graft and patient survival rates can be obtained in Type 1 diabetic patients, although they remain poorer than those of patients with non-diabetic renal disease. More rigorous pretransplantation cardiac assessment and treatment before acceptance of Type 1 diabetic patients for renal transplantation may help to improve patient survival.
对1981年至1990年间在曼彻斯特皇家医院接受肾脏移植的所有1型糖尿病患者进行了移植肾和患者存活率的研究。在此期间，52例因糖尿病肾病导致终末期肾衰竭的1型（胰岛素依赖型）糖尿病患者接受了移植。将他们与在年龄、性别和移植年份上匹配的对照组进行比较，也与同期接受移植的所有904例患者进行比较。糖尿病患者1年和5年的移植肾存活率较低（分别为80.8%和62.1%），而对照组分别为88.9%和77.9%（p = 0.02），但与所有移植肾的存活率相似（分别为80.4%和59.0%，p =无显著性差异）。糖尿病患者5年的精算患者存活率（76.3%）低于对照组（94.2%，p = 0.003）。心肌梗死是糖尿病患者死亡的主要原因（60%）。近期这个大型系列研究的结果表明，1型糖尿病患者可以获得较好的移植肾和患者存活率，尽管仍低于非糖尿病肾病患者。在接受1型糖尿病患者进行肾移植之前，进行更严格的移植前心脏评估和治疗可能有助于提高患者存活率。
