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Transplanted functional islet mass: donor islet preparation, and recipitent factors influence early graft function in islet-after-kidney patients
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
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2012 (English)In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 93, no 6, 632-638 p.Article in journal (Refereed) Published
Abstract [en]

Background.

The ability to predict clinical function of a specific islet batch released for clinical transplantation using standardized variables remains an elusive goal.

Methods.

Analysis of 10 donor, 7 islet isolation, 3 quality control, and 6 recipient variables was undertaken in 110 islet-after-kidney transplants and correlated to the pre- to 28-day posttransplant change in C-peptide to glucose and creatinine ratio ([DELTA]CP/GCr).

Results.

Univariate analysis yielded islet volume transplanted (Spearman r=0.360, P<0.001) and increment of insulin secretion (r=0.377, P<0.001) as variables positively associated to [DELTA]CP/GCr. A negative association to [DELTA]CP/GCr was cold ischemia time (r=-0.330, P<0.001). A linear, backward-selection multiple regression was used to obtain a model for the transplanted functional islet mass (TFIM). The TFIM model, composed of islet volume transplanted, increment of insulin secretion, cold ischemia time, and exocrine tissue volume transplanted, accounted for 43% of the variance of the clinical outcome in the islet-after-kidney data set.

Conclusion.

The TFIM provides a straightforward and potent tool to guide the decision to use a specific islet preparation for clinical transplantation.

Place, publisher, year, edition, pages
2012. Vol. 93, no 6, 632-638 p.
Keyword [en]
Islet transplantation, Pretransplant evaluation, Transplant outcome, Prediction, Islet-After-Kidney
National Category
Surgery Immunology in the medical area
Identifiers
URN: urn:nbn:se:uu:diva-170920DOI: 10.1097/TP.0b013e3182455912ISI: 000301350100014PubMedID: 22258287OAI: oai:DiVA.org:uu-170920DiVA: diva2:509743
Funder
Swedish Research Council, K2011-65X-12219-15-6NIH (National Institute of Health), 2U01AI065192-06Swedish Childhood Cancer Foundation
Available from: 2012-03-13 Created: 2012-03-13 Last updated: 2017-12-07Bibliographically approved

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Friberg, Andrew S.Malm, HeleneNilsson, BoTufveson, GunnarKorsgren, Olle

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