Insulin secretion and action after pancreas transplantation. A retrospective single-center study

Figures & data

Table 1. Mean (SD) or percentage of baseline characteristics in patients who underwent pancreas and kidney transplantation (SPK) or pancreas transplantation alone (PTA).

	SPK (n = 79)	PTA (n = 80)
Age (years)	42.4 (7.1)	40.2 (9.8)
Females (%)	33	50
BMI recipients (kg/m^2)	23.7 (3.3)	25.5 (3.3)
BMI donors (kg/m^2)	23.8 (3.1)	23.1 (4.5)
HLA-A, -B, DR- mismatch, n (%)
0–2	7 (9%)	8 (10%)
3–4	38 (48%)	47 (59%)
5–6	31 (39%)	20 (25%)
Cold ischemia time (minutes)	543 (160)	512 (164)

SPK: simultaneous pancreas and kidney transplantation; PTA: pancreas transplantation alone; BMI: body mass index.

HLA mismatch: missing data from 3 patients in the SPK and 5 patients in the PTA group.

Table 2. Clinical status in 159 patients 52 weeks after simultaneous pancreas and kidney transplantation (SPK) or pancreas transplantation alone (PTA).

	SPK (n = 79)	PTA (n = 80)	Total (n = 159)
Death during the first year after transplantation	0	2	2
Insulin dependent after graftectomy due to acute surgical complications	6	5	11
Daily insulin users	3	16	19
Normoglycaemic without insulin treatment	64	52	116
Missing data	6	5	11

Table 3. Mean (SD) of glucometabolic parameters and immunosuppressive therapy eight and 52 weeks after transplantation in patients in the SPK and PTA groups.

	SPK			PTA
	8 weeks post Tx	52 weeks post Tx	p	8 weeks post Tx	52 weeks post Tx	p
FPG (mmol/L)	5.4 (0.8)	5.3 (1.2)	.34	5.5 (0.8)	5.5 (1.4)	.82
C-peptide (pmol/L)	1576 (684)	1057 (288)	.001	1421 (671)	1043 (490)	.003
HOMA2 (%S)	28.60 (19.3)	42.6 (32.7)	.008	31.1 (20.9)	42.9 (29.1)	.002
HOMA2 (%B)	194 (58)	163 (44)	<.001	182 (72)	157 (63)	.36
CPGCR	2.7 (1.2)	2.0 (0.8)	<.001	2.9 (1.6)	2.1 (0.8)	<.001
eGFR (mL/min/1.73m^2)	67.7 (21.5)	68.9 (22.0)	.53	81.8 (26.4)	78.2 (23.8)	.04
Prednisolone dose (mg/day)	11.3 (3.8)	5.4 (1.6)	<.001	12.7 (5.6)	5.5 (1.7)	<.001
Trough tacrolimus concentration (µg/L)	9.3 (2.9)	7.8 (2.3)	.006	9.6 (3.5)	8.0 (2.0)	.012

Includes all patients with data at baseline and 52 weeks (n = 101–127 for different parameters).

SPK: simultaneous pancreas and kidney transplantation; PTA: pancreas transplantation alone; FPG: fasting plasma glucose; HOMA(%S): Homeostasis Model Assessment of insulin sensitivity; HOMA(%B): Homeostasis Model Assessment of beta cell function; CPGCR: C-peptide (pmol/l)/FPG (mmol/l) × P-Creatinine (µmol/l) eGFR = estimated glomerular filtration rate (CKD-EPI formula).

Figure 1. Time courses for (A) C-peptide, (B) eGFR and (C) fasting glucose after organ transplantation. Time courses within each group (‘PTA’ and ‘SPK’), the average group difference (‘Group’) and the time by group effect (‘Int’) are annotated on the panels as effect size (Beta = B) with 95% confidence intervals and a corresponding p-value. The right indents represent areas under the curve (AUC) for each group. SPK = Simultaneous pancreas and kidney transplantation, PTA: pancreas transplantation alone. *p < .05, **p < .01 and p < .001. The box-and-whiskers depict median, inter quartile range (IQR) and min and max values (no further than 1.5 × IQR). The thick lines connect the medians. The thin lines represent data from each individual.

Figure 2. Time courses for (A) CPGCR, (B) HOMA2-%B and (C) HOMA2-%S after organ transplantation. Time courses within each group (‘PTA’ and ‘SPK’), the average group difference (‘Group’) and the time by group effect (‘Int’) are annotated on the panels as effect size (Beta = B) with 95% confidence intervals and a corresponding p-value. The right indents represents areas under the curve (AUC) for each group. SPK = Simultaneous pancreas and kidney transplantation, PTA: pancreas transplantation alone. *p < .05, **p < .01 and p < .001. The box-and-whiskers depict median, inter quartile range (IQR) and min and max values (no further than 1.5 × IQR). The thick lines connect the medians. The thin lines represent data from each individual.