title: Transplanted functional islet mass:  donor, islet preparation, and recipient factors influence early graft function in islet-after-kidney patients.
abstract: 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 (ΔCP/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 ΔCP/GCr. A negative association to ΔCP/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.
  
  
  CONCLUSIONS
  The TFIM provides a straightforward and potent tool to guide the decision to use a specific islet preparation for clinical transplantation.
authors.affiliation: Division of Clinical Immunology, Department of Immunology, Genetics and Pathology, University Hospital, Uppsala, Sweden. andrew.friberg@igp.uu.se
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Friberg
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Lundgren
authors.forename: Helene
authors.initials: H
authors.lastname: Malm
authors.forename: Marie
authors.initials: M
authors.lastname: Felldin
authors.forename: Bo
authors.initials: B
authors.lastname: Nilsson
authors.forename: Trond
authors.initials: T
authors.lastname: Jenssen
authors.forename: Lauri
authors.initials: L
authors.lastname: Kyllönen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Tufveson
authors.forename: Annika
authors.initials: A
authors.lastname: Tibell
authors.forename: Olle
authors.initials: O
authors.lastname: Korsgren
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D002478:Cells, Cultured; D050377:Cold Ischemia; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D003928:Diabetic Nephropathies / Q000601:surgery; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007328:Insulin; D007515:Islets of Langerhans / Q000033:anatomy & histology / Q000502:physiology*; D016381:Islets of Langerhans Transplantation / Q000502:physiology* / Q000592:standards*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009929:Organ Size; D011786:Quality Control; D012189:Retrospective Studies; D014019:Tissue Donors; D014180:Transplantation / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D003404:Creatinine