An Examination of Donor Factors That Impact the Results of the Glucagon Stimulation Test as an Assessment of the Pancreatic Graft Endocrine Function. Issue 6 (13th July 2022)

• Record Type: Journal Article
• Authors: Ito, Taihei; Kenmochi, Takashi; Aida, Naohiro; Hiratsuka, Izumi; Matsushima, Hajime; Kurihara, Kei; Suzuki, Atsushi; Shibata, Megumi; Kusaka, Mamoru; Hasegawa, Midori; Ishihara, Takuma; Go, Hirofumi; Yabusaki, Kohei; Shintani, Ayumi
• Is Part Of: Pancreas. Volume 51:Issue 6(2022)
• Page Start: 634
• Page End: 641
• Publication Date: 2022-07-13
• Subjects: pancreas transplantation -- brain-dead donors -- glucagon stimulation test -- delta C-peptide; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000002093
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: Delta C-peptide derived by the glucagon stimulation test is a reliable value for the evaluation of the pancreatic endocrine function after pancreas transplantation. We examined the associations between delta C-peptide as pancreatic graft endocrine function and donor background factors. Methods: Sixty-five cases of pancreatic transplantation from brain-dead donors, which were performed in our facility, were enrolled in this study. Enrolled recipients underwent a glucagon stimulation test within 1 to 3 months after transplantation to evaluate the pancreatic graft endocrine function with delta C-peptide to compare donor background factors. Results: The following factors were associated with significant deterioration of the delta C-peptide: age of 50 years or greater, death from cerebrovascular accident, hemoglobin A1c level of 5.6% or greater, creatinine level of 1.0 mg/dL or greater, C-reactive protein level of 25 mg/dL or greater, and sodium level of 150 mmol/L or greater. In addition, increased numbers of these donor factors indicated significantly greater deterioration of the posttransplant pancreatic endocrine function ( P < 0.001). Conclusions: To secure insulin independence after pancreas transplantation, which means maintaining a delta C-peptide level of 1.0 ng/mL or greater on a glucagon stimulation test, the utilization of donors, who possesses more than equal to 3 of the donor factors identified in this study, should be carefully considered.