Hormonal and Metabolic Effects of a Pancreatic Endocrine Graft

Abstract

A new modification of pancreas transplant technique, the vascularized segmental i.p. graft without duct ligation, has provided reversal of insulin-dependent (type I) diabetes mellitus for as long as 2 yr of comfortable life. Although the risks associated with immunosuppression remain high (2 of the 12 patients have died of early postoperative infection), selected data are presented from 6 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 h urine C-peptide excretion and acutely responsive serum insulin, restoration or normal suppressibility of plasma glucagon, elimination of ketosis and negative nitrogen balance, normal fasting plasma glucose and glycosylated Hb and normal or near-normal glucose tolerance. These results provide a standard for current explorations of new ways of treating insulin-dependent diabetes.