A total of 117 (101 primary and 16 secondary) renal transplants were performed on 101 diabetic patients. The mean duration of diabetes mellitus to the onset of end-stage renal disease was 17.5 years. After primary transplantation, overall one- and five-year patient survival was 77% and 55%, respectively; for grafts, it was 58% and 45%, respectively. One- and five-year living-related donor graft survival was 66% and 53%, respectively; for cadaveric kidneys, it was 45% and 33%, respectively. One- and five-year graft survival for 20 HLA-identical living-related donor kidneys was 85% and 77%, respectively. Among the 16 recipients of secondary grafts, patient survival at one and five years was 65% and 29%, respectively; graft survival at one year was 24%. Acceptable patient and graft survival continues with primary renal transplantation. In view of the poor results with secondary transplantation in the diabetic patient, however, its continued application should be questioned.
Okiye SE, Engen DE, Sterioff SS, et al. Primary and Secondary Renal Transplantation in Diabetic Patients. JAMA. 1983;249(4):492–495. doi:10.1001/jama.1983.03330280038026
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