HYPOGLYCEMIA FOLLOWING PANCREATIC ALLOGRAFT TRANSPLANTATION

Pancreatic transplantation is an established treatment for patients wi th insulin-dependent diabetes mellitus. Side-effects are mainly relate d to surgical complications, immunosuppressive therapy and graft rejec tion. We report on two patients having recurrent hypoglycaemic events following pancreatic transplantation. The cause of hypoglycaemia in ou r patients remained obscure. Hypoglycaemia following pancreatic transp lantation has been described. Hypoglycaemic events may appear years af ter transplantation. In the article we review three possible mechanism s of hypoglycaemia: hyperinsulinaemia, secondary to systemic drainage (due to loss of first pass hepatic insulin clearance), presence of ant iinsulin antibodies and persistence of counter-regulatory abnormalitie s. Physicians and patients should be aware of possible hypoglycaemia e vents following transplantation.