Comparative evaluation of simple indices of graft function after islet transplantation

Andrea Caumo, Paola Maffi, Rita Nano, Livio Luzi, Robert Hilbrands, Pieter Gillard, Daniel Jacobs-Tulleneers-Thevissen, Antonio Secchi, Bart Keymeulen, Daniel Pipeleers, Lorenzo Piemonti

Research output: Contribution to journalArticle

Abstract

Background.: Several simple measures of graft function after islet transplantation have been proposed but a comparative evaluation is lacking. Here, we compared the performance of five indices of β-cell function: β-score, transplant estimated function (TEF), homeostasis model assessment (HOMA) 2-B%, C-peptide/glucose ratio, and Secretory Units of Islets in Transplantation (SUIT). Methods.: Two cohorts of transplanted patients were analyzed. Cohort 1 consisted of 14 recipients with type 1 diabetes of islet transplantation whereas cohort 2 consisted of 21 recipients with type 1 diabetes of cultured islet cell graft. The five surrogate indices were compared against the first-and second-phase insulin response to arginine in cohort 1, and against the C-peptide response to a hyperglycemic clamp in cohort 2. Results.: We found that the performances of the five surrogate indices were close one to each other in cohort 1. The correlation coefficients ranged 0.62 to 0.67 and 0.62 to 0.68 against the first-and second-phase insulin response to arginine, respectively. In cohort 2, we found that the β-score, TEF, C-peptide/glucose ratio, and SUIT were reasonably well correlated with the clamp response (correlation coefficients were in the range 0.71-0.81), whereas HOMA2-B% showed a modest performance (r=0.54). HOMA2-B% could not be evaluated in one patient whose fasting glucose concentration level was below the lower bound indicated by the HOMA calculator (3 mmol/L). SUIT could not be evaluated in three patients whose fasting glucose concentration was below the glucose threshold of the SUIT formula (3.43 mmol/L). Conclusion.: In summary, no single index ouperformed the others. Nevertheless, when the benefit to cost ratio is considered, TEF stands out for its good performance at a very low cost.

Original languageEnglish
Pages (from-to)815-821
Number of pages7
JournalTransplantation
Volume92
Issue number7
DOIs
Publication statusPublished - Oct 15 2011

Keywords

  • Insulin secretion
  • Islet transplantation
  • Modeling

ASJC Scopus subject areas

  • Transplantation

Fingerprint Dive into the research topics of 'Comparative evaluation of simple indices of graft function after islet transplantation'. Together they form a unique fingerprint.

  • Cite this