Donor insulin use predicts beta‐cell function after islet transplantation

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 United Kingdom (UK) Transplant Registry and the UK Islet Transplant Consortium - all first-time transplants between 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 = 0.02), higher 3-month post-transplant HbA1c levels (5.4 [2.6] mmol/mol, p = 0.04) and lower fasting c-peptide levels (-107.9 [46.1] pmol/l, p = 0.02). Glucose at 10512 time points were 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: 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. This article is protected by copyright. All rights reserved.