Lipids increase after solitary pancreas transplantation

OBJECTIVE - The aims of this study were to determine 1) changes in lipids a fter solitary pancreas transplantation (SPTX) in patients with type 1 diabe tes and 2) factors that influence those changes. RESEARCH DESIGN AND METHODS - Lipids were evaluated prospectively in 24 pat ients who underwent SPTX. Three were excluded because of early graft failur e. The remaining patients (n = 21; 13 men, 8 women) were studied for change s in lipids over time (pre-SPTX, 0-2, 3-6, 7-12, and >12 months). Glycohemo globin, serum creatinine, BMI, and medications were also analyzed for their effects on lipid changes. RESULTS - Cholesterol, HDL, and LDL decreased in the immediate postoperativ e period (0-2 months), whereas triglycerides (TGs) increased (P < 0.05). At 3-6 months, cholesterol, HDL, and TG were higher than before the SPTX, whe reas LDL returned to pre-SPTX levels. After 12 months, HDL and TG remained higher than their pre-SPTX levels (P < 0.05). During the study, systolic an d diastolic blood pressure increased, renal function decreased, glycohemogl obin improved, and weight was unchanged. Changes in cholesteroI/HDL ratio, HDL, and TG correlated with changes in prednisone dose (P < 0.05), and chan ges in TG correlated with changes in creatinine (P < 0.05). The same patter n of lipids occurred in patients prescribed or not prescribed hypolipidemic agents. CONCLUSIONS - Lipids do not improve within the 1st year after SPTX, despite improved glycemic control and brood pressure control, and renal function i s worse. These results are in contrast to those reported for combined kidne y-pancreas transplantation, where lipids, blood pressure, and renal functio n improved immediately after transplant. Further studies are needed to dete rmine whether lipids continue to change with time after SPTX. The impact of these changes after SPTX on overall cardiovascular risk is unknown.