Estimation of Beta Cell Function after Total Pancreatectomy with Islet Autotransplantation Using Single Fasting Blood Sample Based Indices and Modified Igls Score.
1Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
2Surgery, University of Chicago, Chicago
3Medicine, University of Chicago, Chicago.
Meeting: 2018 American Transplant Congress
Abstract number: A360
Keywords: Islets, Monitoring
Session Information
Session Name: Poster Session A: Pancreas and Islet: All Topics
Session Type: Poster Session
Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Background: For precise yet logistically feasible evaluation of beta-cell function after total pancreatectomy with islet autotransplantation (TPIAT), we investigated the utility 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 BETA-2 score.
Methods: Laboratory values from postoperative clinical evaluations were analyzed. The six surrogate indices were compared against 90-min serum glucose in mixed meal tolerance test (MMTT), beta-score and a modified version of the Igls score, which we propose for the assessment of islet function in the setting of IAT.
Results: We analyzed values from 32 MMTT tests in 15 patients with after TPIAT (8 women/7 men). Mean age was 39 ± 12,8 years and follow up 3 years. Four (27%) stopped insulin completely prior to day 75 maintaining A1c of 5.8% (5.2-6.3). Seven in 13 patients (54%) did not require insulin support at 1 year with A1c 6.0% (5.5-6.8). The remaining 6 patients were on insulin with A1c 6.7% (5.5-8.4). All 3 patients who completed 2-year follow-up are currently off insulin with A1c of 5.8%. SUITO, CP/G, TEF and BETA-2 were well correlated with MMTT 90-min and peak glucose and beta-score (r in the range 0.5–0.72), whereas CP/GCr and HOMA-2B showed a modest performance (r = 0.3). Upon ROC analysis all surrogate indices reliably identified insulin independence and optimal/good vs. marginal islet function in modified Igls score, while BETA-2 and TEF showed the best performance with AUROC 0.85-0.99 (95% confidence interval 0.7-1.0, p<0.001). BETA-2 ≥ 9.11 differentiated between good and marginal islet function according to our modification of Igls score for IAT. BETA-2 ≥ 16.45 detected insulin independence.
Conclusions: Using a single fasting blood sample SUITO, CP/G, TEF and BETA-2 scores offer a simple and valid alternative tool allowing frequent assessments of graft function in patients undergoing TPIAT.
CITATION INFORMATION: Gołębiewska J., Bachul P., Basto L., Kijek M., Fillman N., Cieply K., Golab K., Wang L., Tibudan M., Thomas C., Dębska-Ślizień A., Fung J., Witkowski P. Estimation of Beta Cell Function after Total Pancreatectomy with Islet Autotransplantation Using Single Fasting Blood Sample Based Indices and Modified Igls Score. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Gołębiewska J, Bachul P, Basto L, Kijek M, Fillman N, Cieply K, Golab K, Wang L, Tibudan M, Thomas C, Dębska-Ślizień A, Fung J, Witkowski P. Estimation of Beta Cell Function after Total Pancreatectomy with Islet Autotransplantation Using Single Fasting Blood Sample Based Indices and Modified Igls Score. [abstract]. https://atcmeetingabstracts.com/abstract/estimation-of-beta-cell-function-after-total-pancreatectomy-with-islet-autotransplantation-using-single-fasting-blood-sample-based-indices-and-modified-igls-score/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress