title: Evaluation of insulin independence using 11C-methionine positron emission tomography after living-donor and brain-dead donor pancreas transplantation.
abstract: We recently reported that (11)C-methionine positron-emission tomography (PET) is clinically useful for the evaluation of the pancreatic function of the living donor. The objective of this study was to evaluate the postoperative insulin independence in 10 living donor (LD) and 10 brain-dead donor (BD) pancreas transplantations for 20 patients with type I diabetes mellitus by using (11)C-methionine PET. After 6 months, PET/computed tomography was performed 30 minutes after (11)C-methionine (370-740 MBq) injection. The uptake in the pancreas was expressed as the standardized uptake value (SUV). Patient survival rates were 100% at 5 years for LD transplantations and at 2 years for BD transplantations. Insulin independence was 60% for LD transplantations at 5 years and 75% for BD transplantations at 2 years. There were no major surgical complications such as vascular thrombosis, intra-abdominal abscess, and graft pancreatitis. The SUVs for LD and BD pancreas transplantations with insulin independence were 7.2 ± 1.8 and 10.4 ± 2.3, respectively. The SUVs for LD pancreas transplantations with insulin dependence and BD pancreas transplantations with graft failure were 3.6 ± 1.1 and 2.9 ± 1.0, respectively. At 5 years after transplantation, for the LD transplants, the insulin-independent rate was 100% for the graft recipients with an SUV higher than 5, and the median insulin independence duration of the graft recipients with an SUV less than 5 was 7 months (P < .01). The (11)C-methionine PET may be a potent modality to predict long-term insulin independence and the avoidance of pancreas graft failure.
authors.affiliation: Department of Surgery, National Chiba-East Hospital, Chiba, Japan. Electronic address: otsuki@cehpnet.com.
authors.forename: K
authors.initials: K
authors.lastname: Otsuki
authors.affiliation: National Institute of Radiological Sciences, Chiba, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yoshikawa
authors.affiliation: Department of Transplantation Surgery, Fujita Health University, Nagoya, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kenmoshi
authors.affiliation: Department of Surgery, National Chiba-East Hospital, Chiba, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Akutsu
authors.affiliation: Department of Surgery, National Chiba-East Hospital, Chiba, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Maruyama
authors.affiliation: Department of Surgery, National Chiba-East Hospital, Chiba, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Asano
authors.affiliation: Department of Surgery, National Chiba-East Hospital, Chiba, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Saigo
authors.affiliation: Department of Surgery, National Chiba-East Hospital, Chiba, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Surgery, National Chiba-East Hospital, Chiba, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Aoyama
authors.affiliation: Department of Surgery, National Chiba-East Hospital, Chiba, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Matsumoto
authors.affiliation: Department of Transplantation Surgery, Fujita Health University, Nagoya, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.affiliation: Chiba Ryogo Center, PET Imaging Division, Chiba, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Uchino
mesh_terms: D000328:Adult; D001926:Brain Death; D002096:C-Peptide / Q000097:blood; D002250:Carbon Radioisotopes; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D019520:Living Donors; D008297:Male; D008715:Methionine; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000502:physiology; D016035:Pancreas Transplantation; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D002096:C-Peptide; D002250:Carbon Radioisotopes; D006442:Glycated Hemoglobin; D008715:Methionine; D019275:Radiopharmaceuticals; C517652:hemoglobin A1c protein, human