Donor insulin use predicts beta-cell function after islet transplantation

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Petros Yiannoullou
  • Hussein Khambalia
  • Catherine Fullwood
  • John Casey
  • Shareen Forbes
  • Miranda Rosenthal
  • Paul Rv Johnson
  • Pratik Choudhary
  • James Bushnell
  • James A M Shaw
  • David van Dellen

Abstract

Insulin is routinely used to manage hyperglycaemia in organ donors and during the peri-transplant period in islet transplant recipients. However, it is unknown whether donor insulin use (DIU) predicts beta-cell dysfunction after islet transplantation. We reviewed data from the UK Transplant Registry and the UK Islet Transplant Consortium; all first-time transplants during 2008-2016 were included. Linear regression models determined associations between DIU, median and coefficient of variation (CV) peri-transplant glucose levels and 3-month islet graft function. In 91 islet cell transplant recipients, DIU was associated with lower islet function assessed by BETA-2 scores (β [SE] -3.5 [1.5], P = .02), higher 3-month post-transplant HbA1c levels (5.4 [2.6] mmol/mol, P = .04) and lower fasting C-peptide levels (-107.9 [46.1] pmol/l, P = .02). Glucose at 10 512 time points was recorded during the first 5 days peri-transplant: the median (IQR) daily glucose level was 7.9 (7.0-8.9) mmol/L and glucose CV was 28% (21%-35%). Neither median glucose levels nor glucose CV predicted outcomes post-transplantation. Data on DIU predicts beta-cell dysfunction 3 months after islet transplantation and could help improve donor selection and transplant outcomes.

Bibliographical metadata

Original languageEnglish
Pages (from-to)1874-1879
Number of pages6
JournalDiabetes, Obesity and Metabolism
Volume22
Issue number10
DOIs
Publication statusPublished - 25 May 2020