Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*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.
To cite this abstract in AMA style:Kanak MA, Saravanan P, Kalivarathan J, Shindo Y, Levy MF. Predicting Metabolic Outcomes in Islet Autotransplantation before Transplantation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/predicting-metabolic-outcomes-in-islet-autotransplantation-before-transplantation/. Accessed September 25, 2020.
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