Insulin Secretory Profiles and C-Peptide Clearance Kinetics at 6 Months and 2 Years After Kidney-Pancreas Transplantation

Diabetes ◽  
1992 ◽  
Vol 41 (10) ◽  
pp. 1346-1354 ◽  
Author(s):  
J. D. Blackman ◽  
K. S. Polonsky ◽  
J. B. Jaspan ◽  
J. Sturis ◽  
E. V. Cauter ◽  
...  
Keyword(s):  
Pancreas Transplantation ◽  
C Peptide ◽  
Clearance Kinetics

Insulin secretory profiles and C-peptide clearance kinetics at 6 months and 2 years after kidney-pancreas transplantation

Diabetes ◽  
1992 ◽  
Vol 41 (10) ◽  
pp. 1346-1354 ◽  
Author(s):  
J. D. Blackman ◽  
K. S. Polonsky ◽  
J. B. Jaspan ◽  
J. Sturis ◽  
E. Van Cauter ◽  
...  
Keyword(s):  
Pancreas Transplantation ◽  
C Peptide ◽  
Clearance Kinetics

scholarly journals SUN-624 Low Risk of Major Adverse Cardiovascular Events After Pancreas Transplantation Alone

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Ravinder Jeet Kaur ◽  
Byron H Smith ◽  
Shafaq R Rizvi ◽  
Sreedhar Batthula ◽  
Aleksandra Kukla ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Pancreas Transplantation ◽  
Graft Failure ◽  
Event Rate ◽  
Major Adverse Cardiovascular Events ◽  
C Peptide ◽  
Duration Of Diabetes ◽  
Post Transplant ◽  
Increased Risk

Abstract INTRODUCTION: Type 1 Diabetes (T1D) patients have an increased risk for major adverse cardiovascular events (MACE). Pancreas Transplantation Alone (PTA) in patients with T1D achieves near normal glucose control for a prolonged period but limited data are available to date regarding MACE during a 10 year follow up period after the procedure. OBJECTIVE: We studied incidence of MACE after PTA in T1D patients over a 10 year follow-up period. METHODS: Retrospectively, we studied 113 T1D recipients of PTA at Mayo Clinic, Rochester with the procedure performed between January 1998 and August 2018 and follow up of at least 1 year. Data were collected before transplantation and up to 10 year follow up after the first PTA. MACE data were gathered until primary non function, re-transplantation, or complete loss of c-peptide (<0.01ng/ml). We report vascular risk factors including hypertension, hyperlipidemia, smoking and BMI along with MACE (defined as cardiac events as unstable angina, Myocardial Infarction (MI), need for re-vascularization, cardiac death, cerebral events as Transient ischemic attack (TIA), stroke, need for re-vascularization and peripheral arterial disease as need for re-vascularization, gangrene and amputation). RESULTS: Eighteen subjects had pre-transplant MACE. A total of 14 subjects had graft failure within 24 to 36 hours due to thrombosis, with 3 in pre-transplant MACE cohort and 11 in no MACE cohort. Thus, we followed 99 subjects for the development of post-transplant MACE for a period of 6.3 ± 3.6 years. T1D subjects with MACE (n=15) had baseline characteristics: Age 48± 7.8 years, gender F/M 9/6,, duration of diabetes 33 ± 12 years, BMI 26± 3.1(Kg/m2), HbA1c 9.3 ± 1.5% and C-peptide 0.09 ng/ml. 84 T1D patients without MACE were age 42 ± 10.6 years, gender F/M 55/29, duration of diabetes 26.5 ± 10.7 years, BMI 26 ± 5.2(Kg/m2), HbA1c 6.7 ± 2.5 and C-peptide 0.09 ng/ml. There are a total of 584 person-years of follow up to first MACE event and 632 person-years of graft failure, death or last follow-up. Nine patients developed 11 MACE events post-PTA. Therefore, the event rate is 1.5 MACE events per 100 person-years for first MACE event and the total event rate is 1.7 MACE events per 100 person-years of follow-up. Age, smoking (yes), gender, duration of diabetes, HTN and Hyperlipidemia presence did not show any significant impact on post-transplant MACE outcome based on univariate Cox regression but the pre-transplant BMI (HR = 1.14; CI = (1.04, 1.26); p = 0.008) and pre-transplant HbA1c (HR = 1.26; CI = (1.06, 1.51); p = 0.01) showed statistically significant impact. CONCLUSIONS: At our center, MACE is low in PTA recipients. There is no impact of presence of pre-transplant MACE on development of post-transplant MACE but pre-transplant BMI and HbA1c account for risk of MACE.

scholarly journals C-peptide and combined kidney-pancreas transplantation

2009 ◽  
Vol 2 (6) ◽  
pp. 489-492
Author(s):  
R. Bhargava ◽  
N. Mitsides ◽  
I. Saif ◽  
P. MacDowall ◽  
A. Woywodt
Keyword(s):  
Pancreas Transplantation ◽  
C Peptide

SIMULTANEOUS KIDNEY-PANCREAS TRANSPLANTATION FOR ESRD PATIENTS WITH INSULIN-DEPENDENT DIABETES AND DETECTABLE C-PEPTIDE

2010 ◽  
Vol 90 ◽  
pp. 982
Author(s):  
R. J. Knight ◽  
A. Lawless ◽  
S. J. Patel ◽  
K. Achkar ◽  
A. Abdellatif ◽  
...  
Keyword(s):  
Pancreas Transplantation ◽  
Insulin Dependent Diabetes ◽  
C Peptide ◽  
Insulin Dependent ◽  
Esrd Patients

scholarly journals Prospective Longitudinal Study Evaluating Comprehensive Metabolic and Life Style Characteristics of Pancreas Transplantation Recipients

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A461-A461
Author(s):  
Ravinder Jeet Kaur ◽  
Shafaq R Rizvi ◽  
Corey Reid ◽  
Shelly K McCrady-Spitzer ◽  
Patrick Dean ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Dietary Intake ◽  
Glucose Control ◽  
Pancreas Transplantation ◽  
Dietary Assessment ◽  
Graft Function ◽  
Target Range ◽  
C Peptide ◽  
Significant Difference

Abstract Introduction: Pancreas Transplantation (PT) improves quality of life in Type 1 Diabetes (T1D) patients but limited longitudinal data are available regarding comprehensive metabolic assessment and lifestyle. Our objective was to comprehensively assess T1D patients who underwent PT (PTA and SPK) ≥ 1 year prior on two separate visits 1 year apart. Methodology: We studied 12 PT recipients ≥1 year post PT. Two assessments 1 year apart included comprehensive assessment of graft function using standard mixed meal tolerance test (MMTT), Continuous Glucose Monitoring (CGM) for 1 week, body composition using DEXA scan, physical activity using ActiGraph for 1 week and dietary assessment by VIOCARE®. Results: PT recipients (9F) were 55.5± 9.7 years old, 91.7 % Caucasian with 34.9 ± 12.3 years of diabetes, 6.7 ± 5.2 years (range-1.3–17.6 years) after PT. Ten participants underwent Pancreas Transplantation alone and two received Simultaneous Pancreas Kidney transplantation. Visit 1(V1) showed HbA1c 5.5 ± 0.7%, Fructosamine 238.4 ± 25.6 mcmol/L, BMI 31.2 ± 6.7 kg/m2, fasting plasma glucose (FPG) 95.2 ± 19.4mg/dL and C-peptide 2.6 ± 1.0 ng/ml and visit 2 (V2) HbA1c 5.5 ± 0.6%, Fructosamine 244.4 ± 41.3 mcmol/L, BMI 29.9 ± 5.1kg/m2, FPG 95.4 ± 27.7mg/dL, and C-peptide 2.5 ± 0.8 ng/ml (p-value not significant). One week CGM (n=9) showed excellent glucose control at both visits with mean glucose 117.8 ± 7.0 vs.112 ± 6.2 mg/dl and 96.3 ± 3.6 vs. 96.9±2.8 % time in target range (70-180mg/dl). Time >180mg/dl and >250mg/dl were 2.7 ± 3.0 vs. 1.3±1.7 % (p=0.0413) and 0.2 ± 0.6 vs. 0.1 ± 0.1 % respectively. Mild CGM hypoglycemia (<70 mg/dl) was observed during both visits (1.0 ± 1.0 vs. 1.7± 2 %). CV was 21.1 ± 5.5 and 20.1 ± 4.8 %. Eight recipients underwent MMTT and showed excellent response to Boost® with no significant difference between visits with exception of insulin concentrations at 60 mins (increased from V1) and 90 mins (decreased from V1) (p=0.0424 and 0.0235). DEXA (n=10) revealed similar total % mean fat, and fat distribution in arms, legs and trunk. ActiGraph (n=10) showed similar physical activity during both visits with 16761 ± 5176 and 14499 ± 4192 average steps/day respectively. Mean MET score was 1.6 ± 0.4 and 1.6 ± 0.2 indicating light intensity activity during both periods. Total mean sedentary bouts increased over 1 year (49.6 ± 39.1 vs. 60.8 ± 43.7, p=0.0038). Dietary assessment in 11 recipients showed no significant difference in dietary intake with calories intake 1.3± 0.4 vs. 1.2±0.5 daily Harris-Benedict and macronutrient intake with fat of 36.7 ± 4.3 % and 36.5 ± 5.7 %, CHO of 45.7 ± 5.5 % and 45.7 ± 5.5 % and Omega-3 of 0.1 ± 0.1 g and 0.05 ± 0.1 g respectively. Conclusion: PT recipients have excellent glucose control and pancreas graft function 1 or more years after PT when assessed over successive 2 years with suboptimal body composition and dietary intake and above average physical activity.

Urinary C-Peptide: Unsuitable Parameter of  -Cell Secretion in Pancreas Transplantation

Diabetes Care ◽  
1987 ◽  
Vol 10 (3) ◽  
pp. 384-385 ◽  
Author(s):  
E. Esmatjes ◽  
J. M. Calvet ◽  
M. J. Ricart ◽  
L. Fernandez-Cruz ◽  
R. Casamitjana ◽  
...  
Keyword(s):  
Pancreas Transplantation ◽  
Cell Secretion ◽  
C Peptide

Preoperative C-Peptide Predicts Weight Gain After Pancreas Transplantation

2020 ◽  
Vol 30 (2) ◽  
pp. 117-124
Author(s):  
Julia Torabi ◽  
Juan P. Rocca ◽  
Elizabeth Kestenbaum ◽  
Maria Ajaimy ◽  
Monica DeFeo ◽  
...  
Keyword(s):  
Weight Gain ◽  
Pancreas Transplantation ◽  
Cardiovascular Complications ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Rapid Weight Gain ◽  
C Peptide ◽  
Hemoglobin A ◽  
Single Center Study ◽  
Percentage Weight

Background: Transplant recipients are susceptible to cardiovascular complications, obesity, and increased insulin resistance after transplant. Here we assess weight gain in diabetic recipients after pancreas transplantation. Methods: This is a single-center study of 32 simultaneous pancreas and kidney and 5 pancreas after kidney transplant recipients from 2014 to 2018. Starting C-peptide levels ≤ 0.1 ng/mL were used to denote insulin nondetectability (n = 25) and C-peptide levels > 0.1 ng/mL as insulin detectability (n = 12). Hemoglobin A1c, body mass index (BMI), and weight following transplantation were assessed. Results: Hemoglobin A1c at 1 year was 5.9% in the insulin nondetectable recipients and 5.6% in the insulin detectable group ( P = .56). Average BMI after transplant was higher in the insulin detectable group 28.6 versus 24.4 kg/m2 ( P = .03) despite no difference in starting BMIs (24.9 versus 24.0 kg/m2, P = .42). The insulin detectable group also had a larger percentage weight change from their starting weight 13.1% versus 0.9 % at 1 year ( P = .02). Linear regression demonstrated that starting C-peptide was a significant predictor of weight gain posttransplant. Conclusions: Patients with elevated C-peptides at time of transplant are susceptible to rapid weight gain postoperatively. These patients may benefit from aggressive nutritional management.

Pancreas Transplantation in C-Peptide Positive Patients: Does “Type” of Diabetes Really Matter?

2015 ◽  
Vol 220 (4) ◽  
pp. 716-727 ◽  
Author(s):  
Robert J. Stratta ◽  
Jeffrey Rogers ◽  
Alan C. Farney ◽  
Giuseppe Orlando ◽  
Hany El-Hennawy ◽  
...  
Keyword(s):  
Pancreas Transplantation ◽  
C Peptide

Elevated C-peptide Levels Are Associated With Acute Rejection in Kidney Pancreas Transplantation

2020 ◽  
Vol 52 (3) ◽  
pp. 987-991
Author(s):  
Wen Y. Xie ◽  
Vivian C. McAlister ◽  
Kyle Fiorini ◽  
Alp Sener ◽  
Patrick P. Luke
Keyword(s):  
Acute Rejection ◽  
Pancreas Transplantation ◽  
C Peptide
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