Diabetic muscle infarction after simultaneous pancreas-kidney transplant

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Spiros Delis1, Gaetano Ciancio, Javier Casillas

  • 1Department of Surgery, Division of Transplantation, University of Miami School of Medicine, Miami, FL 33101, USA.

Clinical Transplantation
|July 9, 2002
PubMed

Insights

Diabetic muscle infarction (DMI) is a rare complication in patients with type 1 diabetes. This study highlights DMI occurring post-kidney-pancreas transplant in patients with end-stage renal disease and diabetes, suggesting underlying diabetic complications contribute.

Area of Science:

  • Endocrinology
  • Nephrology
  • Vascular Medicine

Background:

  • Diabetic muscle infarction (DMI) is a rare complication typically seen in patients with long-standing type 1 insulin-dependent diabetes mellitus (IDDM).
  • End-stage renal disease (ESRD) often coexists with long-term diabetic complications.

Observation:

  • This case series describes four patients with IDDM and ESRD who developed DMI approximately 5 months after simultaneous kidney-pancreas transplantation (SPK).
  • These patients exhibited pre-existing diabetic complications like retinopathy, neuropathy, microangiopathy, and hypercoagulability, known risk factors for DMI.

Findings:

  • Despite achieving normoglycemia post-transplantation, DMI occurred, indicating that pre-existing tissue damage from labile glycemic control and hypertension plays a role.
  • The use of calcineurin inhibitors and steroids in immunosuppressive regimens may exacerbate DMI risk due to their pro-coagulant effects.

Implications:

  • DMI can occur even after successful SPK in patients with a history of long-term diabetes and its complications.
  • Understanding these contributing factors is crucial for managing and potentially preventing DMI in this vulnerable patient population.

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