Background:Precise yet logistically feasible evaluation of beta-cell function is extremely important after islet allotransplantation. We investigated the utility and possible limitations of indices using only single fasting blood glucose and C-peptide levels: The Secretory Unit of Islet Transplant Objects (SUITO), transplant estimated function (TEF), homeostasis model assessment (HOMA)2-B%,C-peptide/glucose ratio(CG/G), C-peptide/glucose creatinine ratio (CP/GCr) and recently introduced BETA-2 score.

Methods: Laboratory values from clinical evaluations in recipients of allogenic islet grafts were analyzed at different times post islet infusion. The six surrogate indices were compared against the gold standard of 90-min serum glucose and peak glucose in MMTT and beta-score according to patient's gender, median patient's BMI and insulin resistance (IR) estimated with HOMA-IR.

Results: We analyzed values from 48 MMTT tests in 4 long-term (LT group) allogeneic islet grafts recipients with up to 126 months follow up and values from 47 MMTT tests in 13 patients with up to 2 year follow up (ST group). All 4 patients in LT group remained insulin-free over 7 years. In ST group, 12 out of 13 patients are currently still insulin-free. Patients required subsequent islets infusions as their graft function fluctuated over time. SUITO, CP/G, HOMA2-B% and BETA-2 were reasonably well correlated with MMTT 90-min and peak glucose and beta-score (r in the range 0.33–0.57 in LT group, and 0.64-0.82 in ST group), whereas CP/GCr and TEF showed a modest performance (r 0.22-0.66 and 0.03-0.32, respectively). In both LT and ST group IR seemed to affect strength of the relationship (r for higher IR up to 0.57 in LT group, and 0.77 in ST group vs r for lower IR up to 0.83 in LT group, and 0.85 in ST group), while we did not find any consistent pattern when influence of gender and BMI was analyzed.

Conclusions:Using a single fasting blood sample SUITO, CP/G, HOMA2-B% and BETA-2 scores offer simple and valid alternative tool allowing frequent assessments of graft function, but should be used with caution in patients with high insulin resistance.

CITATION INFORMATION: Golebiewska J, Solomina J, Konsur E, Cieply K, Basto L, Kotukhov A, Golab K, Thomas C, Debska-Slizien A, Witkowski P. Assessment of Simple Indices Based on a Single Fasting Blood Sample in Search for an Optimal Tool to Estimate Beta Cell Function After Islet Transplantation. Am J Transplant. 2017;17 (suppl 3).

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