Long-term follow-up of glycaemic control and parameters of lipid transport after pancreas transplantation

Abstract

Summary. We report the long-term metabolic observations made on 37 patients after simultaneous pancreas and kidney transplantation. Plasma C-peptide levels were above the physiological range in all patients and there was no significant difference between patients undergoing delayed duct occlusion (n=12) or those with drainage of exocrine secretion into the urinary bladder (n=25). HbA 1,, was equally at the upper end of the normal range in both subsets of patients. Mean fasting cholesterol (237 mg/dl) and triglycerides (122 mg/dl) were normal, and HDL-cholesterol was above normal with an average concentration of 77 mg/dl. Two patients underwent an oral fat tolerance test and showed extremely low postprandial lipaemia and very high lipoprotein lipase activities. We conclude that patients with a functioning pancreas graft persistently demonstrate normoglycaemia, elevated Cpeptide, and a very favourable lipid profile both in the fasting and the postprandial state.

Impact of pancreas transplantation on diabetic secondary complications and quality of life

“…There was also a remarkably normal postprandial triglyceride clearance in pancreas recipients after an oral fat tolerance test due to a high post-heparin lipoprotein lipase activity [86]. A decrease of triglycerides and total cholesterol was also noted in another study [87], however, these lipid changes were seen both in kidney only and kidney/pancreas recipients.…”

“…Recent studies however could demonstrate a favourable effect of pancreas and kidney transplantation on serum lipids [85][86][87][88][89]. While lipid status of subjects with IDDM and renal failure was abnormal before pancreas-kidney transplantation, cholesterol fell sharply during the immediate postoperative period ( < 2 months), but increased afterward.…”

Orthotopic pancreas transplantation with portal venous drainage in rats Surgical technique and metabolic effects

“…Type I diabetic patients who had received a kidney and heterotopic pancreas transplant with systemic venous drainage were hyperinsulinemic but developed low lipidemia and high HDL cholesterol levels postprandially [9,14,15,19]. This favourable lipid profile was attributed to an increased lipoprotein lipase activity in fatty tissue, leading to an excellent triglyceride clearing capacity [15].…”