[Organ transplantation in diabetics patients with ESRD]

Because of the increased incidence of end-stage renal disease (ESRD) secondary to diabetes mellitus (DM, organ transplantation in this population is a growing issue. Renal transplantation is the best therapeutic option. Patient survival for both Type I and type II DM patients, is improved by organ transplantation compared to dialysis. For type I DM, this improvement is also observed after combined kidney-pancreas transplantation (KPT). These results have been obtained by the improvement of surgical technique and immunosuppressive treatments. The characteristics of transplantation for DM patients are: 1. The need for early pre-transplantation evaluation with a special attention for ischemic cardiopathy. 2. The possibility of SPK for Type I or Type II DM patients if they are young, non-obese and with a marked endogenous insulin secretion decrease. The perspective for organ transplantation in diabetic patients with ESRD is islet transplantation. This technique has proven its efficacy for patients with no renal disease. Recent results show that islet transplantation may be successful in patients after renal transplantation.