Follow-up study of sensory-motor polyneuropathy in type 1 (insulin-dependent) diabetic subjects after simultaneous pancreas and kidney transplantation and after graft rejection

• Published in: Diabetologia Vol. 34 Suppl 1; p. S113
• Main Authors: Müller-Felber, W, Landgraf, R, Wagner, S, Mair, N, Nusser, J, Landgraf-Leurs, M M, Abendroth, A, Illner, W D, Land, W
• Format: Journal Article
• Language: English
• Published: Germany 01.08.1991
• Subjects: Adult; Diabetes Mellitus, Type 1 - physiopathology; Diabetes Mellitus, Type 1 - surgery; Diabetic Nephropathies - physiopathology; Diabetic Nephropathies - surgery; Diabetic Neuropathies - physiopathology; Electrophysiology; Female; Follow-Up Studies; Graft Rejection; Humans; Kidney Transplantation - immunology; Kidney Transplantation - physiology; Male; Median Nerve - physiopathology; Neural Conduction; Neurons, Afferent - physiology; Pancreas Transplantation - immunology; Pancreas Transplantation - physiology; Peroneal Nerve - physiopathology
• ISSN: 0012-186X
• DOI: 10.1007/BF00587634

The influence of successful simultaneous pancreas and kidney transplantation on peripheral polyneuropathy was investigated in 53 patients for a mean observation period of 40.3 months. Seventeen patients were followed-up for more than 3 years. Symptoms and signs were assessed every 6 months using a standard questionnaire, neurological examination and measurement of sensory and motor nerve conduction velocities. While symptoms of polyneuropathy improved (pain, paraesthesia, cramps, restless-legs) and nerve conduction velocity increased, there was no change of clinical signs (sensation, muscle-force, tendon-reflexes). Following kidney-graft-rejection there was a slight decrease of nerve conduction velocity during the first year, which was not statistically significant. Following pancreas-graft rejection there was no change of nerve conduction velocity during the first year. Comparing the maximum nerve conduction velocity of the patients with pancreas-graft-rejection to the nerve conduction velocities of these patients at the end of the study, there was a statistically significant decrease of 6.5 m/s. In conclusion, we believe that strict normalization of glucose metabolism alters the progressive course of diabetic polyneuropathy. It may be stabilized or partly reversed after successful grafting even in long-term diabetic patients.