ISSN:
1432-0428
Keywords:
Glucose
;
Lipids
;
Lipoproteins
;
Pancreatic graft rejection
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary Long-term metabolic control after pancreatic transplantation with enteric exocrine diversion was evaluated in 42 Type I (insulin-dependent) diabetic pancreas recipients with functioning grafts for 1 to 7 years. Glycaemic control (fasting blood glucose, glycosylated haemoglobin A1c, oral and intravenous glucose tolerance tests) was normal or near-normal in most patients, and showed no deterioration with time. In ten patients with functioning grafts for 5 years there was a small, but significant, improvement in the glucose control at 3 to 5 years as compared with that at 6 months post-operatively. In the latter recipients the number of acute rejection episodes correlated negatively with the intravenous glucose tolerance at 6 months (r=−0.64, p〈0.01) and at 5 years (r=−0.60, p〈0.01) after transplantation, respectively. The glycaemic control at 6 and 12 months after transplantation was similar whether segmental (n=35) or whole-organ (n=7) pancreatic grafts had been used. In six non-uraemic recipients who had received a pancreas transplant alone the serum cholesterol increased in all but one patient (0.05〈p〈0.1), and the LDL/HDL-cholesterol ratio was significantly higher (p〈0.005) one year after transplantation than before. Conversely, in six diabetic patients who had lost the function of their single pancreatic grafts the lipid and lipoprotein profiles remained unaltered. It is concluded that the long-term glycaemic control after segmental or whole-organ pancreatic transplantation with enteric exocrine diversion remains essentially normal in most recipients, and it may even improve with time. The short- and long-term glucose control seems to be adversely influenced by the number of acute rejections. Moreover, in non-uraemic pancreas transplant recipients the lipoprotein profile changed towards a more atherogenic pattern. The latter findings are probably attributable to the immunosuppressive therapy.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00587625
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