Impact of type 1 and type 2 diabetes mellitus on pancreas transplant outcomes

Vinayak Rohan*, David Taber, Arun Palanisamy, John McGillicuddy, Kenneth Chavin, Prabhakar Baliga, Charles Bratton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objectives: Pancreas transplant improves quality of life and survival of patients irrespective of pretransplant C-peptide levels. Our objectives were to examine complications and outcomes in patients without measureable C-peptide (insulin-dependent type 1 diabetes mellitus) and carefully selected patients with measurable C-peptide (insulin-dependent type 2 diabetes mellitus) after pancreas transplant. Materials and Methods: We conducted a retrospective analysis to examine the demographic, transplant factors, complications, and outcomes in patients with nondetectable pretransplant C-peptide (insulin-dependent type 1 diabetes mellitus) and patients with detectable pretransplant C-peptide (insulin-dependent type 2 diabetes mellitus). Results: Of 214 consecutive pancreas transplant procedures over a 12-year period, 112 had pretransplant C-peptide level testing (63 patients with type 1 and 49 with type 2 diabetes mellitus). Patients with type 1 disease were more likely to be female (P =.048), and patients with type 2 disease were more likely to be African American (P <.001) and have undergone previous pancreas transplant (P =.042). We observed no differences in donor factors or posttransplant factors (C-peptide after year 2, glucose, and hemoglobin A1C, except that patients with type 2 disease had more pancreatitis) (P =.036). There were no differences in posttransplant complications; however, patients with type 2 disease had significantly higher BK virus nephropathy (P =.006). There were no differences in outcomes between cohorts (rejection, graft loss, or death; P = not significant). Conclusions: Pancreas transplant can be performed with excellent and equivalent outcomes in patients with type 1 and carefully selected type 2 diabetes mellitus. Patients with type 2 disease are more likely to have posttransplant pancreatitis and BK virus nephropathy, affecting the net benefit for transplant.

Original languageEnglish (US)
Pages (from-to)796-802
Number of pages7
JournalExperimental and Clinical Transplantation
Volume17
Issue number6
DOIs
StatePublished - Dec 2019

Keywords

  • C-peptide
  • Complications
  • Insulin-dependent diabetes mellitus
  • Pancreas transplantation

ASJC Scopus subject areas

  • Transplantation

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