Evaluation of engraftment after single islet transplantation from a brain-dead donor by the secretory unit of islet transplant objects (SUITO) index.
BACKGROUND
Evaluation of engraftment is important to assess the success of islet transplantation. Recently, we developed a simple index of islet engraftment, the secretory unit of islet transplant objects (SUITO) index. The formula is: 1500 x fasting C-peptide level [ng/dL]/(fasting blood glucose levels [mg/dL]-63). A SUITO index of more than 26 was associated with insulin independence.


METHODS
In this study, we compared islet engraftment efficacy using the SUITO index after a single infusion of islets from brain-dead donors into 6 recipients. We calculated the SUITO index from postoperative days 3 to 30. We compared the insulin reduction rate with the SUITO index and islet equivalent per kilogram body weight (IE/Kg). We also measured the level of glycosylated hemoglobin (HbA 1C) at 3 months posttransplantation to assess glycemic control after islet transplantation.


RESULTS
In 5 cases, islets were cultured before transplantation and in 1 case they were transplanted without culture. Without culture, the SUITO index and insulin reduction rate were highest. The SUITO index significantly correlated with the insulin reduction rate (P = .031, R2 = .728), but the IE/kg was not significantly correlated (P = .303) with the rate of insulin reduction. All cases showed improved HbA 1C to the normal range.


CONCLUSIONS
Immediate transplantation without culture substantially improved the efficacy of engraftment of transplanted islets. The SUITO index was a better predictor than islet mass per body weight for clinical outcomes.
Matsumoto
S
S
Baylor All Saints Medical Center/Baylor Research Institute, Fort Worth, Texas 76104, USA. shinichi41@mac.com
Noguchi
H
H
Hatanaka
N
N
Kobayashi
N
N
Jackson
A
A
Naziruddin
B
B
Levy
M -F
M-
D001786:Blood Glucose / Q000378:metabolism; D001926:Brain Death; D002096:C-Peptide / Q000097:blood; D018929:Cell Culture Techniques; D006801:Humans; D007328:Insulin / Q000097:blood; D007515:Islets of Langerhans / Q000166:cytology; D016381:Islets of Langerhans Transplantation / Q000379:methods / Q000502:physiology*; D018579:Patient Selection; D014019:Tissue Donors; D016896:Treatment Outcome
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin