*Purpose: Total Pancreatectomy with Islet Auto-transplantation (TPIAT) has been actively performed on patients with severe, debilitating pain of chronic pancreatitis. The outcome of islet transplantation is affected by several variables such as Pre-transplant islet function, peri-transplant inflammation, poor revascularization etc. Patient selection for TPIAT is of major concern, and there is a need to predetermine metabolic outcomes for careful selection of patients for this procedure. Our group has previously reported the use of SUITO index as a measure of beta cell function. In this study, ΔC-peptide and Δ SUITO index has been devised to evaluate outcome of transplantation.

*Methods: A total of 28 patients underwent TPIAT at Virginia Commonwealth University. The patient’s beta cell function was evaluated prior to surgery by measuring, Hba1C, blood glucose and c-peptide at basal and stimulated conditions. The SUITO index at both basal and stimulated conditions was calculated using the formula: SUITO = 1500 X C-peptide_{(basal/stimulated)} level [ng/dL]/(Blood Glucose_{(basal/stimulated)} level [mg/dL] – 63) ΔC-peptide is the difference between the basal and stimulated c-peptide and the ΔSUITO index is the difference between basal and stimulated SUITO indices. A Pearson correlation analysis of Δc-peptide and ΔSUITO index with final IEQ, Hba1C, C-peptide, insulin dose and glucose level at 3month, 6month and 1 year post-transplantation was performed.

*Results: A strong negative correlation between pre-transplant ΔC-peptide with the Hba1C and Glucose level at 6month post transplantation was identified. Furthermore, a positive correlation between ΔC-peptide and SUITO index 6 month post-transplantation was also observed. More interestingly, higher ΔSUITO index was associated with increased islet yield in those patients. ΔSUITO index was also significantly correlated with Hba1C, C-peptide, glucose level and SUITO index at 6 month post-transplantation. Increase in ΔSUITO index was associated with decreased Hba1C and glucose level and increased C-peptide and SUITO index.

*Conclusions: Our data suggests that pre-transplant ΔC-peptide and ΔSUITO index can be used to determine the post-transplant metabolic outcome of the patient before surgery. This information will help the clinicians to evaluate or select patients that would best benefit from the TPIAT procedure.

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