Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Causes of early post-transplant pancreas graft failure are well identified. Indeed, this is not the case after the first year. We searched factors which could be useful in predicting late graft failure, such as recipient and donors’ baseline characteristics, and biological parameters including fasting blood glucose, C-peptide, insulin, amylase, lipase, OGTT, Matsuda index, Beta score, HOMA IR and HOMA B.
*Methods: From January 2000 to December 2015, 354 patients (139 men and 215 women; aged from 17 to 65 years; mean 40) underwent pancreas transplantation (280 SPK, 36 PAK and 38 PTA) in our unit. Median f/u was 6 years. figure).
*Results: Pancreas survival (including death) was 80.5, 70.7 and 67.5% at 1, 3 and 5 years, respectively. Death with functional graft was the main reason for late graft failure (29%). Vascular reasons were the principle origin of death (31%). Deceased donor due to vascular cause was the single parameter of late graft failure (OR 2.02, CI 95%, 1.01-4.05, p=0.04). Multivariate analysis defined Beta score less than 7 (OR 3, CI95%, 1.03-8.72, p=0.044) and more significantly fasting blood glucose above 5.4 mml/L (OR 1.76, CI 95%, 1.21-2.54, p=0.0023) at one year post-transplant as predictive markers of late graft failure. Graft survival was significantly impacted by one year fasting blood glucose more or equal to 5.4 mmol/L (see table).
*Conclusions: Several reasons could induce abnormal blood glucose level in pancreas transplant recipients. Specific management and adapted therapy of an identified cause could probably result in an improvement of results. However, this is in fact not always easy and practicable. Our analysis identified a threshold of fasting glycemia of 5.4 mml/L (i.e. still under normal ranges) at one year which seems to be of interest (as well as the Beta score) in the prediction of late graft failure. Whether lowering this level by medical and/or diet management could result in better long-term results requires confirmation.
To cite this abstract in AMA style:Cantarovich D, Ollivier M, Chaillous L, Cariou B, Branchereau J, Karam G. Fasting Glood Glucose: A Simple and Reliable Marker to Predict Late Pancreas Graft Failure [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/fasting-glood-glucose-a-simple-and-reliable-marker-to-predict-late-pancreas-graft-failure/. Accessed October 29, 2020.
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