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  Vol. 130 No. 3, March 1995 TABLE OF CONTENTS
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Kidney transplantation in diabetic patients using cyclosporine. Five-year follow-up

D. Shaffer, M. A. Simpson, P. N. Madras, A. I. Sahyoun, P. A. Conway, C. P. Davis and A. P. Monaco
Division of Organ Transplantation, New England Deaconess Hospital, Boston, Mass.

OBJECTIVE: To review our center's experience with kidney transplantation in diabetic recipients; specifically, to compare long-term (5-year) patient and graft survival rates between diabetic and nondiabetic recipients overall and according to donor source using cyclosporine-based immunosuppression. DESIGN: A retrospective review of all kidney transplants performed over the 7-year period from 1987 to 1993. SETTING: A large urban tertiary care referral center with a long history of kidney transplantation and care of the diabetic patient. PATIENTS: All patients receiving a kidney transplant, either alone or simultaneously with a pancreas transplant, were reviewed. MAIN OUTCOME MEASURES: Actuarial patient and graft survival, serum creatinine levels, and causes of late graft loss. RESULTS: There was no significant difference in actuarial 5-year patient or kidney graft survival between diabetic and nondiabetic recipients overall or when analyzed by donor source. There was no significant difference in mean serum creatinine levels at 5 years between diabetic and nondiabetic recipients overall or between diabetic and nondiabetic cadaveric recipients. While chronic rejection was the major cause of late graft loss in nondiabetic recipients, death with a functioning graft, principally due to cardiovascular disease, was the major cause of graft loss in diabetic recipients. CONCLUSIONS: With cyclosporine-based immunosuppression, diabetic kidney transplant recipients have 5-year patient and graft survival rates and allograft function comparable to nondiabetic recipients. Given the high mortality of diabetic patients receiving dialysis, kidney transplantation is the treatment of choice for end-stage diabetic renal disease.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Kidney transplantation in type 2 diabetic patients: a comparison with matched non-diabetic subjects
Boucek et al.
Nephrol Dial Transplant 2002;17:1678-1683.
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Two Hundred One Consecutive Living-Donor Nephrectomies
Shaffer et al.
Arch Surg 1998;133:426-431.
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