Dipeptidyl peptidase-4 (DPP4) inhibitor is a well-known oral hypoglycemic agent which not only helps lowering blood glucose level but also enhances the function of beta cells in the pancreas. So far, it has not been determined whether DPP4 inhibitor is beneficial for recipients who have pancreas transplantation when it is administered early post-transplant. The aim of this study is to evaluate whether the administration of DPP4 inhibitors in the early post-operative period improves metabolic outcomes for pancreas transplant recipients.
This is a retrospective study based on medical records from a single center. After excluding six patients with early graft failure, a total of 312 patients who received pancreas transplantation at our center from 2000 to 2018 were enrolled. Among the 312 recipients, 165 had no DPP4 inhibitors or for less than one month (No DPP4 inhibitor group) whereas 147 had DPP4 inhibitors for more than one month (DPP4 inhibitor group). Levels of serum fasting glucose, C-peptide, HbA1c, and insulin were measured 1, 3, 6, 12, 24, and 36 months post-transplant and analyzed through the linear mixed model.
There was no significant difference in levels of glucose, HbA1c, and insulin between two groups During the follow-up period. However, the level of C-peptide maintained significantly higher in the DDP4 inhibitor group one (mean 4.58 ng/mL, CI [4.09-5.12] vs 3.90 ng/mL, [3.48-4.37], p=0.028), six (3.29 ng/mL, [2.93-3.68] vs 2.74 ng/mL, [2.44-3.08], p=0.014), and 24 (2.93 ng/mL, [2.57-3.33] vs 2.42 ng/mL, [2.11-2.77], p=0.032) months post-transplant.
In conclusion, post-transplant DDP4 inhibitor administration may help to improve β cell function after pancreas transplantation.