Renal transplantation in insulin-dependent diabetics. A joint Scandinavian report.

Since 1970 renal transplantation has been carried out in 146 insulin-dependent diabetic patients with renal failure. Patient-survival at one year was 60%, and at two years it was 50%. One-year survival among 25 patients with living donor transplants was 84%. Survival was significantly reduced in patients with heart-disease, impaired vision due to diabetic retinopathy, and a long history of diabetes. Survival was not influenced by sex, age, neuropathy, or pre-transplantation dialysis. Diabetic retinopathy progressed slowly after successful transplantation, and more than 90% had stable vision one to two years after transplantation. Progression of peripheral circulatory insufficiency was common and severe enough to necessitate amputation(s) in 18 patients. One and two years after successful transplantation less than 10% of the patients with a functioning graft needed constant hospital care, and more than 50% were able to work.