Do pretransplant C‐peptide levels predict outcomes following simultaneous pancreas‐kidney transplantation? A matched case‐control study
| Autor: | Colleen L. Jay, Scott Kaczmorski, Alejandra M Mena-Gutierrez, Robert J. Stratta, Komal Gurung, Amber Reeves-Daniel, Berjesh Sharda, Giuseppe Orlando, Jeffrey Rogers, Michael D. Gautreaux, N. Sakhovskaya, Alan C. Farney, Venkat Gurram, William Doares |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Type 2 diabetes Pancreas transplantation Gastroenterology chemistry.chemical_compound Insulin resistance Internal medicine Diabetes mellitus medicine Humans Pancreas Retrospective Studies Transplantation C-Peptide C-peptide business.industry Graft Survival Case-control study medicine.disease Kidney Transplantation Diabetes Mellitus Type 1 chemistry Case-Control Studies Pancreas Transplantation medicine.symptom business Weight gain |
| Zdroj: | Clinical Transplantation. 36 |
| ISSN: | 1399-0012 0902-0063 |
| DOI: | 10.1111/ctr.14498 |
| Popis: | Following simultaneous pancreas-kidney transplantation (SPKT), survival outcomes are reported as equivalent in patients with detectable pretransplant C-peptide levels (Cp+) and a "type 2″ diabetes mellitus (DM) phenotype compared to type 1 (Cp negative [Cp-]) DM. We retrospectively compared 46 Cp+ patients pretransplant (≥2.0 ng/mL, mean 5.4 ng/mL) to 46 Cp- (level 0.5 ng/mL) case controls matched for recipient age, gender, race, and transplant date. Early outcomes were comparable. Actual 5-year patient survival (91% versus 94%), kidney graft survival (69% versus 86%, p = .15), and pancreas graft survival (60% versus 86%, p = .03) rates were lower in Cp+ versus Cp- patients, respectively. The Cp+ group had more pancreas graft failures due to insulin resistance (13% Cp+ versus 0% Cp-, p = .026) or rejection (17% Cp+ versus 6.5% Cp-, p = .2). Post-transplant weight gain 5 kg occurred in 72% of Cp+ versus 26% of Cp- patients (p = .0001). In patients with functioning grafts, mean one-year post-transplant HbA1c levels (5.0 Cp+ versus 5.2% Cp-) were comparable, whereas Cp levels were higher in Cp+ patients (5.0 Cp+ versus 2.6 ng/mL Cp-). In this matched case-control study, outcomes were inferior in Cp+ compared to Cp- patients following SPKT, with post-transplant weight gain, insulin resistance, and rejection as potential mitigating factors. |
| Databáze: | OpenAIRE |
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