Table 3.
Islet yield and metabolic outcome
| Minneapolis | Leicester | Cincinnati | Alabama | |
|---|---|---|---|---|
| Published series where data obtained | Sutherland et al. 200841 | Garcea et al. 20099Webb et al. 200820a | Ahmad et al. 200512 | Argo et al. 20083 |
| Sample size (period of study) | 193 (1977–2007); metabolic follow-up available for 173 patients | 50 (1996–2006) | 45 (2000–2004) | 27 (2005–2007) |
| Time between surgery and islet infusion | Cold ischaemia time = 58+/−24 min Islet preparation time 3.4+/−1.1 h | 2 to 4 h (unpublished data) | ∼4 h | Not reported |
| Islet yield | 1977–1990 (n = 23) IEQ/kg body weight = 2582 +/− 3194 Median 1375 (49–12470) 1991–1994 (n = 15) IEQ/kg body weight = 5296 +/− 4395 Median 4588 (111–17035) 1995–2000 (n = 27) IEQ/kg body weight = 3181 +/− 2523 Median 3121 (225–10000) 2001–2007 (n = 107) IEQ/kg body weight = 3150 +/− 1955 Median 3054 (23–8558) | Median IEQ/g pancreas = 1876 (249–12271)aMedian IEQ transplanted = 130029 (24332–958078)aMedian IEQ/kg body weight = 2245 (405–20385)a | Insulin independet subgroup IEQ/g pancreas = 7304 +/− 1722 IEQ yield = 413542 +/− 70985 IEQ/kg body weight = 6635 +/− 229 Insulin dependent subgroup IEQ/g pancreas = 5025 +/− 968 IEQ yield = 297889 +/− 49480 IEQ/kg body weight = 3799 +/− 629 | Mean IEQ/g pancreas = 2739 +/− 477 Mean IEQ transplanted = 82904 +/− 18223 Mean IEQ/kg body weight = 1331 +/− 304 |
| Glucose control (insulin requirement and C-peptide level) | 32% had full and 33% had partial metabolic function at some post-transplant point | 12 patients (24%) had significant periods (median 16.5 months) of insulin independencea0.17 IU/kg body weight vs. 0.22 IU/kg body weight insulin requirement for purified vs. non-purified groups (P = 0.32)a100% C-peptide positive.a | 40% insulin independence 24% requires 1–20 units/day 20% requires 20–40 units/day 16% requires >40 units/day | None reported insulin independence Mean insulin 17.4 units/day, C-peptide 1 ng/ml, HbA1c 6.7% at 3-months follow up Mean insulin 23 units/day, C-peptide 1.7 ng/ml, HbA1c 7.5% at 6-months follow up |
| Factors influencing metabolic outcome | Islet function correlated with IEQ/kg body weight (P < 0.05). Islet function demonstrated at 1 year for: 32% of recipients with <2500 IEQ/kg had islet function at 1 year 79% of recipients with 2501–5000 IEQ/kg 86% of recipients with >5000 IEQ/kg. | Insulin requirements were similar in recipients of purified and non-purified islets. (P = 0.32)aTrend of increase insulin requirement over time was observed but not statistically significant.a | Higher IEQ/kg body weight in the insulin independent subgroup (P = 0.04) | – |
a
sample size = 46