654 © 2006 The Authors Journal compilation © 2006 Diabetes UK. Diabetic Medicine, 23, 654–659 Correspondence to: Prof. Palmina Petruzzo, Service d′Urologie et Chirurgie de la Transplantation (Pavillon V), Hôpital Edouard Herriot, 5 Place d’Arsonval, 69437 Lyon cedex 03, France. E-mail: petruzzo@pacs.unica.it and palmina.petruzzo@chu-lyon.fr Abstract Aims The aim was to investigate pancreatic B-cell function and insulin sensi- tivity in simultaneous pancreas-kidney (SPK) recipients with systemic or portal venous drained pancreas allograft using simple and easy tests. Methods The study included 44 patients with Type 1 diabetes and end-stage renal disease who had undergone SPK transplantation: 20 recipients received a pancreas allograft with systemic venous drainage (S-SPK) and 24 with portal venous drainage (P-SPK). We studied only recipients with functioning grafts, with normal serum glucose, HbA 1c and serum creatinine values, on a stable drug regimen. The subjects were studied at 6, 12, 24, 36, 48 and 60 months after transplantation. Insulin sensitivity and B-cell function indices were derived from blood samples and oral glucose tolerance tests. Results All patients from both groups had normal fasting glucose, body mass index and HbA 1c values by selection. The homeostatic model (HOMA) β-cell index was significantly lower in P-SPK recipients at several points of the follow- up. HOMA-IR was significantly higher in S-SPK recipients at 6 and 24 months after transplantation and was positively correlated with fasting insulin values, but never exceeded 3.2. There was no significant difference in QUICKI index values between the two groups. Although all patients from both groups always had normal glucose tolerance, the area under the insulin curve was higher in the S-SPK group. Cholesterol, low-density lipoprotein-cholesterol and triglycerides were higher in the P-SPK group. Conclusions The results suggest sustained long-term endocrine function in both groups and show that portal venous drainage does not offer major meta- bolic advantages. Diabet. Med. 23, 654–659 (2006) Keywords HOMA-IR index, insulin resistance, oral glucose tolerance test, pancreatic venous drainage, portal venous drainage, QUICKI index, simultaneous pancreas-kidney transplantation Abbreviations BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; OGTT, oral glucose tolerance test; P-SPK, SPK with portal venous drainage; SPK, simultaneous pancreas-kidney; S-SPK, SPK with systemic venous drainage Blackwell Publishing Ltd Oxford, UK DME Diabetic Medicine 0742-3071 Blackwell Publishing, 2006 23 Original Article Original article Metabolic status in pancreas-kidney transplant P. Petruzzo et al. Metabolic consequences of pancreatic systemic or portal venous drainage in simultaneous pancreas-kidney transplant recipients P. Petruzzo*‡, L. Badet†‡, N. Lefrançois‡, C. Berthillot‡, S. Bin Dorel§, X. Martin‡ and M. Laville¶ *Department of Surgery, University of Cagliari, Cagliari, Italy, †UMR-Mejnr-MMMPAR, Claude-Bernard Lyon 1 University, ‡Service de Chirurgie de la Transplantation, Hôpital Edouard Herriot, §Department of Public Health, Clinical Epidemiology Unit, Bernard Lyon 1 University, ¶Human Nutrition Research Centre of Lyon, Edouard Herriot Hospital and Claude Bernard Lyon 1 University; INSERM; INRA, Lyon, France Accepted 8 December 2005