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Pancreas transplantation alone safe, effective for long-term survival
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SAN FRANCISCO — Pancreas transplantation alone was safe and effective for long-term actual patient survival, insulin independence and improvement of metabolic parameters, according to data presented at the American Diabetes Association’s 74th Scientific Sessions.
“As we know, since the first pancreas transplant alone was performed, improvements in surgical techniques, immunosuppressive therapy and medical knowledge have contributed to ameliorate the outcomes of the procedure in type 1 diabetes patients,” Margherita Occhipinti, MD, of the department of endocrinology and metabolism at the University of Pisa, Italy, said during a presentation here. “Nevertheless, long-term pancreas transplant alone results are still limited and the discussion of the benefits/risks ratio is still ongoing.”
Occhipinti and colleagues examined 34 patients with type 1 diabetes aged 37 years (17 men; 17 women) with a mean BMI of 23.5 kg/m2; mean duration of diabetes for 23.6 years, who underwent pancreas transplantation alone from December 2000 to October 2003.
Ten-year data indicated that patient survival was 97% (33 of 34 patients; 1 death due to stroke but with functioning graft at 5 years post-transplant), and death-censored pancreas survival was 64.7%.
Those with functioning grafts were insulin independent, with a fasting plasma glugose of 96 mg/dL post-transplant vs. 230 mg/dL pre-transplant; HbA1c 5.8% vs. 1.8% (both P<.001). Data also indicated a sustained endogenous insulin secretion, with c-peptide levels of 2.8 ng/mL vs. 0.08 ng/mL (P<.001), respectively.
Total cholesterol (157 mg/dL vs. 193 mg/dL, P<.001) and LDL (95 mg/dL vs. 128 mg/dL, P<.001) also improved significantly after 10 years.
However, systolic blood pressure (126 mmHg vs. 125 mmHg) and diastolic blood pressure (74 mmHg vs. 78 mmHg) appeared similar without a change to hypertension drug maintenance, according to data.
Indexes of cardiac diastolic function did improve significantly, with an increase of left ventricular ejection fracture (54.1% vs. 58.9%, P<.01) observed after transplantation, Occhipinti said.
“Pancreas transplantation alone can be considered an effective and safe procedure for select type 1 diabetes patients,” Occhipinti said. — by Samantha Costa
For more information: Occhipinti M. Abstract 82-OR. Presented at: American Diabetes Association’s 74th Scientific Sessions; June 13-17, 2014; San Francisco.
Disclosure: The researchers report no relevant financial disclosures.