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Effects of pancreas transplantation on established diabetic nephropathy. Although there appears to be a benefit in the prevention of diabetic nephropathy, there does not appear to be a benefit in patients who undergo pancreas transplantation in reversing established diabetic glomerular lesions. In this study, mesangial fractional volume increased (panel A) and mean glomerular volume decreased (panel B) in pancreas transplantation recipients but no significant change in total mesangial volume (panel C) occurred over a 5-year follow-up. (From Fioretto and coworkers [24]; with permission).

FIGURE 15-28 (see Color Plates)

Effects of pancreas transplantation on microvascular disease. The benefits of pancreas transplantation on vascular disease have been variable. A, In this study, thermography demonstrated a clear-cut improvement in diabetic microvascular disease after successful pancreas transplantation [25]. B, However, no evidence exists that successful pancreas transplantation results in the regression of established macrovascular disease.

FIGURE 15-28 (see Color Plates)

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