Hypoglycaemia following pancreatic allograft transplantation.

Pancreatic transplantation is an established treatment for patients with insulin-dependent diabetes mellitus. Side-effects are mainly related to surgical complications, immunosuppressive therapy and graft rejection. We report on two patients having recurrent hypoglycaemic events following pancreatic transplantation. The cause of hypoglycaemia in our patients remained obscure. Hypoglycaemia following pancreatic transplantation has been described. Hypoglycaemic events may appear years after transplantation. In the article we review three possible mechanisms of hypoglycaemia: hyperinsulinaemia, secondary to systemic drainage (due to loss of first pass hepatic insulin clearance), presence of anti-insulin antibodies and persistence of counter-regulatory abnormalities. Physicians and patients should be aware of possible hypoglycaemia events following transplantation.