Key result
A Transplanted Functional Islet Mass model explains ~43% of variance in post-transplant clinical outcomes.
Why the study?
Predicting the clinical function of a specific islet batch released for clinical transplantation using standardized variables remained an elusive goal.
Does the Transplanted Functional Islet Mass (TFIM) model predict clinical function in islet-after-kidney transplants?
Observational (n=110)
Does the Transplanted Functional Islet Mass (TFIM) model predict clinical function in islet-after-kidney transplants?
p-value: p=<0.001
The Transplanted Functional Islet Mass (TFIM) model provides a tool to predict clinical function and guide the decision to use a specific islet preparation for clinical transplantation.
May guide cautious islet batch selection; hypothesis-generating in Level 4 data and requires prospective validation.
BACKGROUND: The ability to predict clinical function of a specific islet batch released for clinical transplantation using standardized variables remains an elusive goal. 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). 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. CONCLUSION: The TFIM provides a straightforward and potent tool to guide the decision to use a specific islet preparation for clinical transplantation.
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Lundgren et al. (2012) conducted an observational in Islet-after-kidney transplants (n=110). Donor, islet isolation, quality control, and recipient variables was evaluated on Pre- to 28-day posttransplant change in C-peptide to glucose and creatinine ratio (ΔCP/GCr) (p=<0.001). A Transplanted Functional Islet Mass model incorporating islet volume, insulin secretion, cold ischemia time, and exocrine tissue volume accounted for 43% of the variance in clinical outcome.
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