PMID- 19708905
OWN - NLM
STAT- MEDLINE
DCOM- 20120112
LR  - 20221207
IS  - 1399-5448 (Electronic)
IS  - 1399-543X (Print)
IS  - 1399-543X (Linking)
VI  - 11
IP  - 4
DP  - 2010 Jun
TI  - Predicting islet yield in pediatric patients undergoing pancreatectomy and 
      autoislet transplantation for chronic pancreatitis.
PG  - 227-34
LID - 10.1111/j.1399-5448.2009.00575.x [doi]
AB  - BACKGROUND/OBJECTIVE: Chronic pancreatitis (CP) in children is associated with 
      significant morbidity and can lead to narcotic dependence. Total pancreatectomy 
      (TP) may be indicated in refractory CP to relieve pain; simultaneous islet 
      autotransplant (IAT) may prevent postsurgical diabetes. About half of pediatric 
      patients are insulin independent 1 yr after IAT. Insulin independence correlates 
      best with the number of islets available for transplantation (islet yield). 
      Currently there is no known method to predict islet yield in a given patient. We 
      assessed the ability of preoperative metabolic tests to predict islet yields in 
      10 children undergoing TP/IAT. DESIGN/METHODS: Hemoglobin A1c (HbA(1c)) and mixed 
      meal tolerance tests (MMTT) were obtained prior to surgery in 10 patients age 
      <or= 18 yr. Fasting glucose, C-peptide, and creatinine were used to calculate the 
      C-peptide to glucose* creatinine ratio (CPGCR). C-peptide peak and area under the 
      curve (AUC) were determined from 2 h MMTT. Linear regressions were performed to 
      predict islet yield from baseline test results. RESULTS: Islet yield ranged from 
      7000 to 434 000 islet equivalents (IE) (mean 222 452 +/- 148 697 IE). Islet yield 
      was well predicted from body weight and fasting plasma glucose (R (2) = 57%, 
      adjusted for overfitting by bootstrap). Islet yield was positively associated 
      with CPGCR, peak C-peptide, and AUC C-peptide and negatively associated with 
      HbA(1c). CONCLUSIONS: Pilot data from 10 pediatric patients suggest that simple 
      preoperative measurement of fasting plasma glucose may give a useful prediction 
      of islet yield. Islet yield correlates with HbA(1c) and C-peptide levels. This 
      information allows individual candidates to weigh the specific risk of becoming 
      diabetic against the benefit of pain relief should they undergo TP-IAT.
FAU - Bellin, Melena D
AU  - Bellin MD
AD  - Department of Pediatrics, University of Minnesota, 420 Delaware Street, 
      Minneapolis, MN 55455, USA. bell0130@umn.edu
FAU - Blondet, Juan J
AU  - Blondet JJ
FAU - Beilman, Gregory J
AU  - Beilman GJ
FAU - Dunn, Ty B
AU  - Dunn TB
FAU - Balamurugan, A N
AU  - Balamurugan AN
FAU - Thomas, William
AU  - Thomas W
FAU - Sutherland, David E R
AU  - Sutherland DE
FAU - Moran, Antoinette
AU  - Moran A
LA  - eng
GR  - T32 DK065519/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20090825
PL  - Denmark
TA  - Pediatr Diabetes
JT  - Pediatric diabetes
JID - 100939345
RN  - 0 (Blood Glucose)
RN  - 0 (C-Peptide)
RN  - 0 (CFTR protein, human)
RN  - 0 (Carrier Proteins)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (SPINK1 protein, human)
RN  - 0 (hemoglobin A1c protein, human)
RN  - 126880-72-6 (Cystic Fibrosis Transmembrane Conductance Regulator)
RN  - 50936-63-5 (Trypsin Inhibitor, Kazal Pancreatic)
RN  - AYI8EX34EU (Creatinine)
RN  - EC 3.4.21.4 (PRSS1 protein, human)
RN  - EC 3.4.21.4 (Trypsin)
SB  - IM
MH  - Adolescent
MH  - Blood Glucose/analysis
MH  - C-Peptide/blood
MH  - Carrier Proteins/genetics
MH  - Child
MH  - Child, Preschool
MH  - Creatinine/blood
MH  - Cystic Fibrosis Transmembrane Conductance Regulator/genetics
MH  - Diabetes Mellitus, Type 1/prevention & control
MH  - Fasting
MH  - Female
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin/therapeutic use
MH  - *Islets of Langerhans
MH  - *Islets of Langerhans Transplantation
MH  - Male
MH  - Pain, Intractable/surgery
MH  - *Pancreatectomy
MH  - Pancreatitis, Chronic/genetics/mortality/*surgery
MH  - Prospective Studies
MH  - Transplantation, Autologous
MH  - Treatment Outcome
MH  - Trypsin/genetics
MH  - Trypsin Inhibitor, Kazal Pancreatic
PMC - PMC7682593
MID - NIHMS1646567
EDAT- 2009/08/28 09:00
MHDA- 2012/01/13 06:00
PMCR- 2020/11/23
CRDT- 2009/08/28 09:00
PHST- 2009/08/28 09:00 [entrez]
PHST- 2009/08/28 09:00 [pubmed]
PHST- 2012/01/13 06:00 [medline]
PHST- 2020/11/23 00:00 [pmc-release]
AID - PDI575 [pii]
AID - 10.1111/j.1399-5448.2009.00575.x [doi]
PST - ppublish
SO  - Pediatr Diabetes. 2010 Jun;11(4):227-34. doi: 10.1111/j.1399-5448.2009.00575.x. 
      Epub 2009 Aug 25.