Beneficial effects of posttransplant dipeptidyl peptidase-4 inhibitor administration after pancreas transplantation to improve beta cell function

Abstract

Purpose: Dipeptidyl peptidase-4 [DPP-4] inhibitors lower blood glucose levels and enhance the function of pancreatic beta cells. Yet, it is unknown whether posttransplant administration of DPP4 inhibitors is beneficial for pancreas transplant recipients.

Methods: We thus retrospectively analyzed the records of 312 patients who underwent pancreas transplantation between 2000 and 2018 at Asan Medical Center (Seoul, Korea) and compared the metabolic and survival outcomes according to DPP-4 inhibitor treatment.

Results: The patients were divided into the no DPP-4 inhibitor group In = 165; no treatment with DPP-4 inhibitors or treated for <1 month) and the DPP-4 inhibitor group In = 147; treated with DPP-4 inhibitors for >= 1 month). There were no significant differences in levels of glucose, hemoglobin Al c, and insulin between the 2 groups during 36 months of follow-up. However, the level of C-peptide was significantly higher in the DPP-4 inhibitor group at 1, 6, and 24 months posttransplant (all P < 0.05). Moreover, the DPP-4 inhibitor group had significantly higher rates of overall (log-rank test, P = 0.009) and death-censored (log-rank test, P = 0.036) graft survival during a 15-year follow-up.

Conclusion: Posttransptant DPP-4 inhibitor administration may help improve the clinical outcomes including j cell function after pancreas transplantation.