Pancreatic endocrine function during early phase following simultaneous pancreas-kidney transplantation in three Japanese cases

We studied pancreatic endocrine function following simultaneous pancreas-kidney transplantation in three Japanese patients after the passing of the transplantation law. Patient 1 was a 39-year-old female. The first phase of insulin secretion in response to intravenous glucose was seen at 12 days after the transplantation but not at 6 days. She was totally free from insulin treatment after 103 days. Patient 2 was a 29-year-old female. Insulin treatment became unnecessary immediately after the transplantation. Insulin secretion was supernormal in the intravenous glucose tolerance test at 6 days. Patient 3 was a 36-year-old female. A non-beating heart donation was performed. Insulin secretion was profoundly suppressed immediately after the transplantation, but recovered after 7 days in accordance with the increase in urinary amylase excretion. Insulin secretion was modest in the first phase but evident in the second phase of insulin secretion at 31 days, and insulin treatment was withdrawn at 30 days. Hyperproinsulinemia was detected in patient 3, whereas pasma glucagon levels were elevated in all three cases. Renal graft functions were equally normalized, but the clinical courses of pancreatic endocrine function varied between the three recipients during the early phase after the simultaneous kidney-pancreas transplantation.