Donor insulin use predicts beta‐cell function after islet transplantation

Iestyn M Shapey, Angela Summers, Petros Yiannoullou, Hussein Khambalia, Catherine Fullwood, Neil A Hanley, John Casey, Shareen Forbes, Miranda Rosenthal, Paul R. V. Johnson, Pratik Choudhary, James Bushnell, James A. M. Shaw, Titus Augustine, Martin K Rutter, David Van Dellen

Research output: Contribution to journalArticlepeer-review


Insulin is routinely used to manage hyperglycaemia in organ donors and during the peri-transplant period in islet transplant recipients. However, it is unknown whether donor insulin use (DIU) predicts beta-cell dysfunction after islet transplantation. We reviewed data from the UK Transplant Registry and the UK Islet Transplant Consortium; all first-time transplants during 2008-2016 were included. Linear regression models determined associations between DIU, median and coefficient of variation (CV) peri-transplant glucose levels and 3-month islet graft function. In 91 islet cell transplant recipients, DIU was associated with lower islet function assessed by BETA-2 scores (β [SE] -3.5 [1.5], P =.02), higher 3-month post-transplant HbA1c levels (5.4 [2.6] mmol/mol, P =.04) and lower fasting C-peptide levels (−107.9 [46.1] pmol/l, P =.02). Glucose at 10 512 time points was recorded during the first 5 days peri-transplant: the median (IQR) daily glucose level was 7.9 (7.0-8.9) mmol/L and glucose CV was 28% (21%-35%). Neither median glucose levels nor glucose CV predicted outcomes post-transplantation. Data on DIU predicts beta-cell dysfunction 3 months after islet transplantation and could help improve donor selection and transplant outcomes.

Original languageEnglish
Pages (from-to)1874-1879
Number of pages6
JournalDiabetes, Obesity and Metabolism
Issue number10
Early online date25 May 2020
Publication statusPublished - 1 Oct 2020


  • insulin
  • islet
  • organ donor
  • pancreas
  • transplant


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