Endothelial function after pancreas transplantation - a single center observational study.

Background Patients with diabetes mellitus treated with successful pancreas transplantation (PTX) normalize hyperglycemia, but are exposed to immunosuppressive drugs that may impair endothelial function. This study aimed to evaluate endothelial function in single PTX recipients. Methods Flow-mediated dilatation (FMD) in the brachial artery was measured by ultrasound 8 weeks after transplantation in single PTX (n = 27) and compared with healthy controls (n = 58), simultaneous pancreas and kidney recipients (n = 9), and kidney transplant recipients with (n = 41) and without (n = 95) diabetes mellitus. Adjustments for age, gender, blood pressure, and body mass index were included in a linear regression model. Changes in FMD from before to 1 year after transplantation were assessed in a subgroup of PTX recipients (n = 9). Results Flow-mediated dilatation% in PTX recipients was not inferior to healthy controls (8.7 +/- 3.6 vs 7.7 +/- 3.3, P = .06) and simultaneous pancreas and kidney recipients (6.7 +/- 4.5, P = .24) in an adjusted model, and superior to kidney recipients with and without diabetes (3.0 +/- 3.0 and 4.8 +/- 3.3, respectively, both P < .005). FMD% improved significantly from eight weeks to one year after PTX, mean 7.9 +/- 4.2% vs 11.8 +/- 4.8% (N = 9; P = .03). Conclusion Flow-mediated dilatation is well preserved in patients undergoing pancreas transplantation and is not impaired when immunosuppressive drugs are introduced.