PMID- 36706060
OWN - NLM
STAT- MEDLINE
DCOM- 20230404
LR  - 20230523
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 107
IP  - 4
DP  - 2023 Apr 1
TI  - Higher Fasting Pretransplant C-peptide Levels in Type 2 Diabetics Undergoing 
      Simultaneous Pancreas-kidney Transplantation Are Associated With Posttransplant 
      Pancreatic Graft Dysfunction.
PG  - e109-e121
LID - 10.1097/TP.0000000000004489 [doi]
AB  - BACKGROUND: Among selected patients with type 2 diabetes mellitus (T2DM), 
      simultaneous pancreas and kidney (SPK) transplants can be an effective option. 
      However, data are limited about outcomes in T2DM SPK recipients based on the 
      pretransplant C-peptide levels. METHODS: In this study, we reviewed all T2DM SPK 
      recipients and categorized them based on the pretransplant fasting C-peptide 
      levels into 3 groups: low (</=2 ng/mL), medium (>2-8 ng/mL), and high (>8 ng/mL). 
      Several measures of graft failures (GFs), graft dysfunction, and composite 
      outcomes were of interest. RESULTS: There were a total of 76 SPK recipients (low, 
      n = 14; medium, n = 47; high, n = 15). At the last follow-up, the low group did 
      not reach any outcome; in contrast, 11 (23%) in the medium group and 5 (33%) in 
      the high group reached the uncensored composite outcome; 6 (13%) in the medium 
      group and 2 (13%) in the high group had GF; and 8 (17%) in the medium group and 4 
      (26.7%) in the high group reached the death-censored composite outcomes. In a 
      fully adjusted model, each pretransplant C-peptide unit was not associated with 
      an increased risk of the composite outcome, GF, or death-censored composite 
      outcomes. However, in multivariate analysis with limited adjustment, 
      pretransplant C-peptide was associated with the composite outcome (hazard ratio: 
      1.18, 95% confidence interval, 1.01-1.38; P = 0.03) and death-censored composite 
      outcome (hazard ratio: 1.20; 95% confidence interval, 1.01-1.42; P = 0.03). 
      CONCLUSIONS: Although limited by the small sample size, we found excellent 
      outcomes among T2DM SPK recipients overall. However, higher levels of 
      pretransplant C-peptide may be associated with inferior posttransplant outcomes 
      that include graft dysfunction.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Parajuli, Sandesh
AU  - Parajuli S
AD  - Division of Nephrology, Department of Medicine, University of Wisconsin School of 
      Medicine and Public Health, Madison, WI.
FAU - Mandelbrot, Didier
AU  - Mandelbrot D
AD  - Division of Nephrology, Department of Medicine, University of Wisconsin School of 
      Medicine and Public Health, Madison, WI.
FAU - Aufhauser, David
AU  - Aufhauser D
AD  - Division of Transplantation, Department of Surgery, University of Wisconsin 
      School of Medicine and Public Health, Madison, WI.
FAU - Kaufman, Dixon
AU  - Kaufman D
AD  - Division of Transplantation, Department of Surgery, University of Wisconsin 
      School of Medicine and Public Health, Madison, WI.
FAU - Odorico, Jon
AU  - Odorico J
AD  - Division of Transplantation, Department of Surgery, University of Wisconsin 
      School of Medicine and Public Health, Madison, WI.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230105
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (C-Peptide)
SB  - IM
CIN - Transplantation. 2023 May 1;107(5):e158. PMID: 37097983
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/complications/diagnosis/surgery
MH  - C-Peptide
MH  - *Diabetes Mellitus, Type 1
MH  - *Kidney Transplantation/adverse effects
MH  - *Pancreas Transplantation/adverse effects
MH  - Pancreas
MH  - Fasting
MH  - Graft Survival
COIS- J.O. receives clinical trial support from Veloxis, Vertex, CareDx, and Natera. 
      S.P. receives clinical trial support from Veloxis pharmaceuticals. The other 
      authors declare no conflicts of interest.
EDAT- 2023/01/28 06:00
MHDA- 2023/04/04 06:42
CRDT- 2023/01/27 13:33
PHST- 2023/04/04 06:42 [medline]
PHST- 2023/01/28 06:00 [pubmed]
PHST- 2023/01/27 13:33 [entrez]
AID - 00007890-202304000-00027 [pii]
AID - 10.1097/TP.0000000000004489 [doi]
PST - ppublish
SO  - Transplantation. 2023 Apr 1;107(4):e109-e121. doi: 10.1097/TP.0000000000004489. 
      Epub 2023 Jan 5.