Metabolic stability of pancreas transplants for type i diabetes: cross-sectional and prospective studies up to fwe years postoperatively

Pancreas transplantation is the most consistently reliable method of achieving normal glycemia and normal HbAlc levels in Type I diabetic patients. Although ample documentation of the immediate beneficial metabolic effects has been reported, no published information exists that addresses their long-term stability. To ascertain long-term stability of metabolic function of 96 recipients, cross-sectional data obtained through five years post-transplantation were analyzed. Values = x ±SE Year Post-Transplant 1 2 31/2 Acute insulin response 135±15 123±13 111±15 116±16 to glucose, )UJ/ml' n=48 n=39 n=22 a=23 Acute C-peptide response 1.13±0.11 0.98±0.14 0.90±0.16 1.30±0.25 to glucose, nmolA.' n=41 n=31 n=14 n=17 Acute glucagon response 292±22 293±26 302±32281±29 to arginine, pg/mF n=44 n=36 n=18 n=22 FPG,mg/dl 85±1 84±2 87±2 88±2 n=50 n=37 n=20 n=24 HbAlc, % (nl<6.0) 5.3±0.1 5.3±0.1 5.4±0.1 5.2±0.1 n=58 n=48 n=23 n=24 T5ormal control subjects: a = 58 ±6, n = 19; b = 1.06 ±0.10, n = 15; c = 156 ±23, n = 18 In addition to these cross-sectional data, prospective data over the five year period in patients receiving at least two and up to five separate assessments revealed no downward trend in metabolic function or maintenance of normal glucose levels in patients who maintained their graft. Conclusion: Successful pancreas transplantation provides pancreatic islet function that results in normal or nearly normal glycémie control for up to five years post-operatively in Type I diabetic recipients receiving no exogenous insulin or oral hypoglycémie agent therapy.