Hormonal and Metabolic Effects of a Pancreatic Endocrine Graft

doi:10.1059/0003-4819-95-5-537

Hormonal and Metabolic Effects of a Pancreatic Endocrine Graft

Vascularized Segmental Transplantation in Insulin-Dependent Diabetic Patients

Minneapolis, Minnesota

Abstract

A new modification of pancreas transplant technique, the vascularized segmental intraperitoneal graft without duct ligation, has provided reversal of insulin-dependent (type I) diabetes mellitus for as long as 2 years of comfortable life. Although the risks associated with immunosuppression remain high (two of the 12 patients have died of early postoperative infection), selected data are presented from six cases to show the following striking hormonal and metabolic results after transplantation and withdrawal of insulin: restoration of normal beta cell function as shown by 24-hour urine C-peptide excretion and acutely responsive serum insulin, restoration of normal suppressibility of plasma glucagon, elimination of ketosis and negative nitrogen balance, normal fasting plasma glucose and glycosylated hemoglobin, and normal or near-normal glucose tolerance. These results provide a standard for current explorations of new ways of treating insulin-dependent diabetes.

Article and Author Information

▸From the Departments of Surgery and Medicine (Section of Endocrinology) and the General Clinical Research Center, University of Minnesota; Minneapolis, Minnesota.
Grant support: by grant RR-400 from the General Clinical Research Center Program of the Division of Research Center Program of the Division of Research Resources, National Institutes of Health; grant AM19269 from the U. S. Public Health Service; and grants from the American Diabetes Association, Minnesota Affiliate, and the Bush Foundation, St. Paul, Minnesota. Dr. Sutherland is a recipient of Research Career Development Award K04 AM 00161 from the U.S. Public Health Service.
▸Requests for reprints should be addressed to Frederick C. Goetz, M.D.; Department of Medicine, Box 93, University of Minnesota Hospitals; Minneapolis, MN 55455.