当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS期刊下所有文献 > Pancreas transplantation in C-peptide positive patients: does "type" of diabetes really matter?

Pancreas transplantation in C-peptide positive patients: does "type" of diabetes really matter?

Abstract：

BACKGROUND:In the past, type 2 (C-peptide positive) diabetes mellitus (DM) was a contraindication for simultaneous pancreas-kidney transplantation (SPKT). STUDY DESIGN:We retrospectively analyzed outcomes in SPKT recipients according to pretransplantation C-peptide levels ≥ 2.0 ng/mL or < 2.0 ng/mL. RESULTS:From November 2001 to March 2013, we performed 162 SPKTs including 30 (18.5%) in patients with C-peptide levels ≥ 2.0 ng/mL pretransplantation (C-peptide positive group, range 2.1 to 12.4 ng/mL) and 132 in patients with absent or low C-peptide levels (<2.0 ng/mL, C-peptide "negative"). C-peptide positive patients were older at SPKT, had a later age of onset and shorter duration of pretransplantation DM, and more were African-American (all p < 0.05) compared with C-peptide negative patients. With a mean follow-up of 5.6 years, patient (80% vs 82.6%), kidney graft (63.3% vs 68.9%), and pancreas graft survivals (50% vs 62.1%, all p = NS) rates were comparable in C-peptide positive and negative patients, respectively. At latest follow-up, there were no differences in acute rejection episodes, surgical complications, major infections, readmissions, hemoglobin A1c levels, serum creatinine, and estimated glomerular filtration rate levels between the 2 groups. C-peptide levels were higher (mean 5.0 vs 2.6 ng/mL, p < 0.05) and post-transplant weight gain (≥ 5 kg) was more common (57% vs 33%, p = 0.004) in the C-peptide positive group. Survival outcomes in C-peptide positive (n = 14) vs C-peptide negative (n = 22) African-American patients were similar, as were outcomes in C-peptide positive patients with a body mass index < or ≥ 28 kg/m(2). CONCLUSIONS:Patients with higher pretransplantion C-peptide levels appear to have a type 2 DM phenotype compared to insulinopenic patients undergoing SPKT. However, survival and functional outcomes were similar, suggesting that pretransplantation C-peptide levels should not be used exclusively to determine candidacy for SPKT.

journal_name

J Am Coll Surg

journal_title

Journal of the American College of Surgeons

authors

Stratta RJ,Rogers J,Farney AC,Orlando G,El-Hennawy H,Gautreaux MD,Reeves-Daniel A,Palanisamy A,Iskandar SS,Bodner JK

doi

10.1016/j.jamcollsurg.2014.12.020

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

716-27

issue

eissn

1072-7515

issn

1879-1190

pii

S1072-7515(14)01912-7

journal_volume

220

pub_type

杂志文章

在线工具

Pancreas transplantation in C-peptide positive patients: does "type" of diabetes really matter?