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Transplanted functional islet mass: donor, islet preparation, and recipient factors influence early graft function in islet-after-kidney patients.
- Source :
-
Transplantation [Transplantation] 2012 Mar 27; Vol. 93 (6), pp. 632-8. - Publication Year :
- 2012
-
Abstract
- Background: The ability to predict clinical function of a specific islet batch released for clinical transplantation using standardized variables remains an elusive goal.<br />Methods: Analysis of 10 donor, 7 islet isolation, 3 quality control, and 6 recipient variables was undertaken in 110 islet-after-kidney transplants and correlated to the pre- to 28-day posttransplant change in C-peptide to glucose and creatinine ratio (ΔCP/GCr).<br />Results: Univariate analysis yielded islet volume transplanted (Spearman r=0.360, P<0.001) and increment of insulin secretion (r=0.377, P<0.001) as variables positively associated to ΔCP/GCr. A negative association to ΔCP/GCr was cold ischemia time (r=-0.330, P<0.001). A linear, backward-selection multiple regression was used to obtain a model for the transplanted functional islet mass (TFIM). The TFIM model, composed of islet volume transplanted, increment of insulin secretion, cold ischemia time, and exocrine tissue volume transplanted, accounted for 43% of the variance of the clinical outcome in the islet-after-kidney data set.<br />Conclusion: The TFIM provides a straightforward and potent tool to guide the decision to use a specific islet preparation for clinical transplantation.
- Subjects :
- Adult
Age Factors
Aged
Blood Glucose metabolism
C-Peptide blood
Cells, Cultured
Cold Ischemia
Creatinine blood
Diabetes Mellitus, Type 1 surgery
Diabetic Nephropathies surgery
Female
Humans
Insulin
Islets of Langerhans anatomy & histology
Male
Middle Aged
Models, Biological
Organ Size
Quality Control
Retrospective Studies
Treatment Outcome
Graft Survival physiology
Islets of Langerhans physiology
Islets of Langerhans Transplantation physiology
Islets of Langerhans Transplantation standards
Kidney Transplantation physiology
Tissue Donors
Transplantation physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1534-6080
- Volume :
- 93
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 22258287
- Full Text :
- https://doi.org/10.1097/TP.0b013e3182455912