Background: We aimed to use microdialysis to assess, for the first time, the internal milieu of pancreatic islet grafts.
Methods: One month after transplantation, microdialysis probes were inserted into syngeneic rat islet transplants (500-700 islets) placed beneath the renal capsule of nondiabetic or diabetic recipients. The number of grafted islets was purposely chosen not to cure the diabetic recipients.
Results: During an intravenous glucose challenge, insulin concentrations increased in parallel in serum and in the graft interstitium of nondiabetic animals suggesting the existence of a functionally well-established vascularization. Diabetic recipients had both a lower serum and dialysate insulin concentration than normoglycemic animals. The lactate/pyruvate ratios were determined in the dialysates as a measure of the degree of anaerobic metabolism in the islet grafts. Lactate/pyruvate ratios were between 50 and 100 in grafts of both nondiabetic and diabetic recipients, and they almost doubled in response to the intravenous glucose challenge in the grafts of nondiabetic recipients. In comparison, lactate/pyruvate ratios were approximately 12 in the medium of cultured islets incubated at low glucose (5.6 mmol/L) or high glucose (16.7 mmol/L) concentrations.
Conclusions: The microdialysis technique has proven to be a valuable tool for evaluating the internal environment of islet transplants. Moreover, the high lactate/pyruvate ratio suggests that islet grafts have an increased anaerobic glucose metabolism.
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http://dx.doi.org/10.1067/msy.2002.126506 | DOI Listing |
Transplantation
January 2025
Faculty of Medicine and Health, University of Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Background: Simultaneous pancreas-kidney (SPK) transplantation is an effective treatment option for type 1 diabetes mellitus and concurrent end-stage kidney disease. However, the diabetogenic effects of immunosuppression can counteract the beneficial effects of sustained normoglycemia. Long-term metabolic trends that reflect cardiovascular risk are reported poorly in the literature.
View Article and Find Full Text PDFTransplant Proc
January 2025
Department of Nephrology, Comprehensive Kidney Disease Research Institute, Yonsei University Wonju College of Medicine, Wonju, Korea; National Health Big Data Clinical Research Institute, Wonju College of Medicine, Wonju, Republic of Korea; Transplantation Center, Yonsei Wonju Christian Hospital. Electronic address:
Background: Dipeptidyl peptidase-4 inhibitors (DPP-4i) are antidiabetic drugs known for their minimal side effects and limited drug interaction witih immunosuppressants, making them suitable for patients with diabetes and kidney transplant recipients. However, there is limited real-world information regarding the use of DPP-4 inhibitors in patients with post transplant diabetes mellitus (PTDM).
Method: We performed a retrospective observational cohort study of 13,828 kidney transplant recipients form Janary 1, 2002, through December 21, 2018, using the Korean National Health Information Database.
World J Surg
January 2025
Collaborative Outcomes Research in Endocrine Surgery (CORES) Lab, Division of Endocrine Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Background: Hyperparathyroidism (HPT) is common in end-stage kidney disease and resolves in less than half of kidney transplant (KT) recipients. The ideal timing of parathyroidectomy (PTX), before or after KT, remains unclear. We sought to understand differences in morbidity and mortality after PTX pre-KT and post-KT.
View Article and Find Full Text PDFClin Kidney J
January 2025
Department of Nephrology-Hypertension, Antwerp University Hospital, Edegem, Belgium.
Background: Although post-transplant diabetes mellitus (PTDM) is a common complication after kidney transplantation, there are few data on prevention, optimal screening, and treatment strategies.
Methods: The European Renal Association's DESCARTES working group distributed a web-based survey to European transplant centres to gather information on risk assessment, screening procedures, and management practices for preventing and treating PTDM in kidney transplant recipients.
Results: Answers were obtained from 121/241 transplant centres (50%) across 15 European countries.
BMC Nephrol
January 2025
Department of Clinical Dietetics, Medical University of Warsaw, Erazma Ciolka 27 Street, Warsaw, 01-445, Poland.
Background: Kidney transplantation (kTx) is by far the most effective method of treating end-stage renal disease, with immunosuppressive therapy being obligatory for all, except identical twins. Despite kTx being the most effective treatment for end-stage renal disease, the patients face significant morbidity. They are often burdened with diabetes, anaemia, lipid disorders, all of which pose heightened risks for cardiovascular disease.
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