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 July 23, 2021.
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