Table 2.
Islet yield, islet composite score, and insulin independence in 10 pediatric patients undergoing total pancreatectomy and islet autotransplant
| Preadolescents |
Adolescents |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Baseline labs: | Islet equivalents | 88 000 | 139000 | 7000 | 92 000* | 158000 | 245 000 | 296 000 | 346 000 | 422 000 | 434 000 |
| One point awarded if: | |||||||||||
| HbA1c | ≤4.8% | 5.3 | 5.4 | 5.5 | 4.7 | 4.9 | 5.7 | 4.8 | 4.8 | 4.4 | 4.3 |
| Peak C-peptide | ≥5 ng/mL | 4.0 | 4.1 | 2.9 | 4.3 | 5.5 | 10.7 | 4.5 | 9.8 | 6.8 | 13.0 |
| AUC C-peptide | ≥492 ng/mL*min | 389 | 302 | 270 | † | 492 | 858 | 378 | 717 | 602 | 966 |
| CPGCR | ≥3.57 | 2.72 | 1.14 | 1.18 | 3.8 | 3.34 | 5.75 | 4.26 | 3.01 | 5.98 | 5.05 |
| Islet composite score | 0 | 0 | 0 | 2 | 2 | 3 | 2 | 3 | 4 | 4 | |
| IE/kg | 3531 | 6362 | 280 | 1808 | 2904 | 3096 | 4287 | 4013 | 5787 | 5977 | |
| Patient age at transplant (years) | 9.9 | 5.1 | 13.3 | 17.0 | 16.3 | 17.6 | 17.4 | 18.4 | 17.5 | 15.6 | |
| Patient weight (kg) | 24 | 22 | 27 | 51 | 54 | 79 | 69 | 86 | 73 | 73 | |
| Insulin use at 6–12 months‡ | Ind. | Ind. | Dep. | Dep. | Dep. | Min. | Min.§ | Dep. | Ind. | Ind. | |
| Insulin use (units/kg/d) | 0 | 0 | 0.57 | 0.36 | 0.41 | 0.22 | 0.07 | 0.35 | 0 | 0 | |
| HbA1c (%) | 5.7 | 6.0 | 8.0 | 12.1 | 6.9 | 5.8 | 5.4 | 7.5 | 5.4 | 5.4 | |
HbA1c, hemoglobin A1c; AUC C-peptide, area under the curve for C-peptide on mixed meal tolerance test; CPGCR, C-peptide to glucose* creatinine ratio.
Patients who had prior Whipple procedure with IAT of unknown IE at outside institution.
Did not complete mixed meal test due to poor venous access; fasting and 90 min C-peptide draw obtained.
Insulin use status categorized as: independent (Ind.), minimal (Min.) = 0.01 – 0.25 units/kg/day, or dependent (Dep.) => 0.25 units/kg/day.
discontinued insulin at 1 month posttransplant; resumed 0.1 units/kg/day glargine at 5.5 months posttransplant for intermittent postprandial hyperglycemia.