title: C-peptide and glucose values in the peritransplant period after intraportal islet infusions in type 1 diabetes.
abstract: BACKGROUND
  Successful islet allograft transplantation has been achieved worldwide. This study aimed at evaluating the relationship between peritransplant C-peptide (CP) values and long-term allograft function.
  
  
  METHODS
  We measured CP-to-glucose ratio (CPGR) in intraportal samples pre- and postinfusion, and in peripheral circulation at baseline pretransplant and at 1, 3, 6, 12, 72 hours, 1 week, and 15 and 30 days after first and second infusion in 13 islet allograft recipients. Peritransplant treatment included intravenous (IV) 5% dextrose in saline in all patients. We compared portal CPGR to insulin reduction (%) at 30 days after each infusion, and at 1 year after second infusion.
  
  
  RESULTS
  CPGR peaked between the immediate postinfusion and 3 hours and decreased at 12 hours. At 1 week, CPGR was 0.76 +/- 0.45 and 1.44 +/- 0.37 after first and second infusion, respectively. CPGR at 30 days after second infusion doubled compared to first infusion (P < .001). There was no correlation between peak CPGR and insulin reduction percent at any time point. One patient experienced hypoglycemia (47 mg/dL) 1 hour after second infusion.
  
  
  CONCLUSIONS
  There was no relationship between the CP values in the peritransplant period and long-term graft function or success rate. The early peak in the C-peptide levels is indicative of a significant insulin release after each islet infusion. For this reason, it is important to carefully monitor serum glucose levels in the peritransplant period (hourly for the first 6 hours) and to maintain an IV glucose infusion to avoid hypoglycemia.
authors.affiliation: Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
authors.forename: R N
authors.initials: RN
authors.lastname: Faradji
authors.forename: K
authors.initials: K
authors.lastname: Monroy
authors.forename: P
authors.initials: P
authors.lastname: Cure
authors.forename: T
authors.initials: T
authors.lastname: Froud
authors.forename: D
authors.initials: D
authors.lastname: Baidal
authors.forename: A
authors.initials: A
authors.lastname: Pileggi
authors.forename: S
authors.initials: S
authors.lastname: Messinger
authors.forename: C
authors.initials: C
authors.lastname: Ricordi
authors.forename: R
authors.initials: R
authors.lastname: Alejandro
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000379:methods* / Q000502:physiology*; D011168:Portal System; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D002096:C-Peptide