PMID: 9541424Apr 16, 1998Paper

Use of glucose disappearance rates (kG) to monitor endocrine function of pancreas allografts

Clinical Transplantation
D S ElmerA O Gaber

Abstract

We have reported that a decline in glucose disappearance rate (kG) in pancreas transplant recipients is associated with pancreatic rejection. The purpose of this study was to determine test-retest reliability of kG monitoring and to establish the kG criteria for diagnosing abnormal graft function. Six healthy non-diabetic volunteers and 14 stable pancreas recipients underwent 2 intravenous glucose tolerance tests 7 d apart. All kG values in non-diabetic volunteers had < 15% variation between the two determinations (r = 0.96, P < or = 0.0006). Similarly, 13/14 recipients experienced < 20% variation in kG with one patients experiencing a 23% variation (r = 0.90, P < or = 0.0001). Using a 20% change from baseline as the reference value, we monitored 28 pancreas recipients for 2-36 months post-transplant. Of 253 kG values, 160 (64%) did not exceed the 20% change from baseline, 65 (26%) declined > 20% and 28 (11%) increased > 20%. Of 160 stable kG values, 154 (96%) were associated with normal graft function while 6 (4%) occurred in the context of rejection. Of 65 kG values declining by > or = 20%, 47 (72%) accurately identified acute rejections diagnosed by biopsy (70%) or response to treatment (30%), 12 (19%) were associated with i...Continue Reading

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