부산대학교 도서관

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1432-2277.2007.00621.x Byline: Georg Biesenbach (1), Peter Biesenbach (1), Gerd Bodlaj (1), Herwig Pieringer (1), Bernhard Schmekal (1), Otmar Janko (1), Raimund Margreiter (2) Keywords: graft survival; pancreas transplantation; smoking; vascular diseases Abstract: Summary We evaluated the impact of smoking on the progression of macro-angiopathy as well as patient and graft survival in 35 type-1 diabetic patients with simultaneous kidney-pancreas transplantation (SKPT). According to their smoking history, the patients were divided into smokers (n = 12) and nonsmokers (n = 23). Mean observation period was 80 (12-168) vs. 84 (12-228) months. The prevalence of vascular diseases as well as the incidence of vascular complications during the observation period was evaluated in each group. Graft- and patient survival were calculated. The prevalence of all vascular diseases was higher in the smokers with prior SKPT at the start as also at the end of study; however, the differences were not significant. In addition, the incidence of vascular complications (stroke, myocardial infarction and amputation) during the follow-up period was higher in the smoking group. Taking all vascular complications together (events/patient/year) the difference was significant (0.105 vs. 0.066, P < 0.05). One- and 5-year patient survival was 100% and 75% for smokers vs. 100% and 91% for nonsmokers. One- and 5-year pancreas graft survival at the same time was 100% and 75% in living smokers as well as 100% and 83% in the nonsmokers: We conclude that smoking after SKPT is associated with a progression of macro-angiopathy. Additionally, mortality after SKPT tends to be higher in smoking patients. Author Affiliation: (1) Second Department of Medicine, Section Nephrology, General Hospital, Linz, Austria (2) Department of General and Transplant Surgery, University Hospital, Innsbruck, Austria Article History: Received: 25 August 2007 Revision requested: 18 September 2007 Accepted: 28 November 2007 Article note: Dr Georg Biesenbach, Second Department of Medicine, Section Nephrology, General Hospital, Krankenhausstrasse 9, A 4020 Linz, Austria. Tel.: 0043 73278066120; fax: 0043 73278066135; e-mail: georg.biesenbach@akh.linz.at