Preoperative C-Peptide Predicts Weight Gain After Pancreas Transplantation.

BACKGROUND: Transplant recipients are susceptible to cardiovascular complications, obesity, and increased insulin resistance after transplant. Here we assess weight gain in diabetic recipients after pancreas transplantation. METHODS: This is a single-center study of 32 simultaneous pancreas and kidney and 5 pancreas after kidney transplant recipients from 2014 to 2018. Starting C-peptide levels ≤ 0.1 ng/mL were used to denote insulin nondetectability (n = 25) and C-peptide levels > 0.1 ng/mL as insulin detectability (n = 12). Hemoglobin A1c, body mass index (BMI), and weight following transplantation were assessed. RESULTS: Hemoglobin A1c at 1 year was 5.9% in the insulin nondetectable recipients and 5.6% in the insulin detectable group (P = .56). Average BMI after transplant was higher in the insulin detectable group 28.6 versus 24.4 kg/m2 (P = .03) despite no difference in starting BMIs (24.9 versus 24.0 kg/m2, P = .42). The insulin detectable group also had a larger percentage weight change from their starting weight 13.1% versus 0.9 % at 1 year (P = .02). Linear regression demonstrated that starting C-peptide was a significant predictor of weight gain posttransplant. CONCLUSIONS: Patients with elevated C-peptides at time of transplant are susceptible to rapid weight gain postoperatively. These patients may benefit from aggressive nutritional management.

Epidemiologic investigation of seroprevalence of antibodies to Toxoplasma gondii in cats and rodents.

OBJECTIVE: To provide an epidemiologic investigation of the seroprevalence of antibodies to Toxoplasma gondii in populations of cats and wild rodents in Rhode Island and to address the possible epidemiologic role of wild rodents in the spread of toxoplasmosis. ANIMALS: 200 cats and 756 small wild rodents. PROCEDURE: Serum samples were obtained from 84 cats in animal shelters and 116 cats in veterinary hospitals. Serum samples were also obtained from 756 small wild rodents from multiple sites in Rhode Island. Sera from rodents and cats were assayed for antibodies to Tgondii by use of the modified agglutination test RESULTS: Overall, 42% (84/200) of cats had serum antibodies to Tgondii. Seroprevalence was not significantly different between stray (50%; 42/84) versus client-owned (36%; 42/116) cats, between male (43%; 40/94) versus female (42%; 39/93) cats, or between indoor (26%; 7/27) versus outdoor (39%; 35/89) cats. Seroprevalence rate of trapped rodents was 0.8% (6/756). Six rodents captured in Washington County accounted for of the seropositive rodents. Four of 6 of the seropositive rodents were trapped at a single site in Washington County (an abandoned barn). Five stray cats, known to have resided at the same site in Washington County as 4 of the seropositive rodents, were also found to be seropositive for antibodies to T gondii. CONCLUSIONS AND CLINICAL RELEVANCE: Seroprevalence rate in rodents was not correlated with the seroprevalence rate in cats. Stray cats, especially those known to be feral, may be more likely to perpetuate the cat-mouse cycle of T gondii than client-owned cats.