PMID- 23924045
OWN - NLM
STAT- MEDLINE
DCOM- 20140527
LR  - 20230124
IS  - 1600-6143 (Electronic)
IS  - 1600-6135 (Print)
IS  - 1600-6135 (Linking)
VI  - 13
IP  - 10
DP  - 2013 Oct
TI  - Metabolic assessment prior to total pancreatectomy and islet autotransplant: 
      utility, limitations and potential.
PG  - 2664-71
LID - 10.1111/ajt.12392 [doi]
AB  - Islet autotransplant (IAT) may ameliorate postsurgical diabetes following total 
      pancreatectomy (TP), but outcomes are dependent upon islet mass, which is unknown 
      prior to pancreatectomy. We evaluated whether preoperative metabolic testing 
      could predict islet isolation outcomes and thus improve assessment of TPIAT 
      candidates. We examined the relationship between measures from frequent sample IV 
      glucose tolerance tests (FSIVGTT) and mixed meal tolerance tests (MMTT) and islet 
      mass in 60 adult patients, with multivariate logistic regression modeling to 
      identify predictors of islet mass >/=2500 IEQ/kg. The acute C-peptide response to 
      glucose (ACRglu) and disposition index from FSIVGTT correlated modestly with the 
      islet equivalents per kilogram body weight (IEQ/kg). Fasting and MMTT glucose 
      levels and HbA1c correlated inversely with IEQ/kg (r values -0.33 to -0.40, p </= 
      0.05). In multivariate logistic regression modeling, normal fasting glucose (<100 
      mg/dL) and stimulated C-peptide on MMTT >/=4 ng/mL were associated with greater 
      odds of receiving an islet mass >/=2500 IEQ/kg (OR 0.93 for fasting glucose, CI 
      0.87-1.0; OR 7.9 for C-peptide, CI 1.75-35.6). In conclusion, parameters obtained 
      from FSIVGTT correlate modestly with islet isolation outcomes. Stimulated 
      C-peptide >/=4 ng/mL on MMTT conveyed eight times the odds of receiving >/=2500 
      IEQ/kg, a threshold associated with reasonable metabolic control postoperatively.
CI  - (c) Copyright 2013 The American Society of Transplantation and the American Society 
      of Transplant Surgeons.
FAU - Lundberg, R
AU  - Lundberg R
AD  - Departments of Surgery, University of Minnesota and University of Minnesota 
      Amplatz Children's Hospital, Minneapolis, MN; Departments of Pediatrics, 
      University of Minnesota and University of Minnesota Amplatz Children's Hospital, 
      Minneapolis, MN.
FAU - Beilman, G J
AU  - Beilman GJ
FAU - Dunn, T B
AU  - Dunn TB
FAU - Pruett, T L
AU  - Pruett TL
FAU - Chinnakotla, S C
AU  - Chinnakotla SC
FAU - Radosevich, D M
AU  - Radosevich DM
FAU - Robertson, R P
AU  - Robertson RP
FAU - Ptacek, P
AU  - Ptacek P
FAU - Balamurugan, A N
AU  - Balamurugan AN
FAU - Wilhelm, J J
AU  - Wilhelm JJ
FAU - Hering, B J
AU  - Hering BJ
FAU - Sutherland, D E R
AU  - Sutherland DE
FAU - Moran, A
AU  - Moran A
FAU - Bellin, M D
AU  - Bellin MD
LA  - eng
GR  - K23 DK084315/DK/NIDDK NIH HHS/United States
GR  - 1K23DK084315-01A1/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20130807
PL  - United States
TA  - Am J Transplant
JT  - American journal of transplantation : official journal of the American Society of 
      Transplantation and the American Society of Transplant Surgeons
JID - 100968638
RN  - 0 (Blood Glucose)
RN  - 0 (C-Peptide)
SB  - IM
MH  - Adult
MH  - Blood Glucose/*metabolism
MH  - C-Peptide/analysis
MH  - Diabetes Mellitus, Type 1/*prevention & control
MH  - Female
MH  - Follow-Up Studies
MH  - Glucose Tolerance Test
MH  - Humans
MH  - Islets of Langerhans/*metabolism
MH  - *Islets of Langerhans Transplantation
MH  - Male
MH  - *Pancreatectomy
MH  - Pancreatitis, Chronic/*surgery
MH  - Postoperative Complications/*prevention & control
MH  - Preoperative Care
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Transplantation, Autologous
PMC - PMC3805695
MID - NIHMS502925
OTO - NOTNLM
OT  - Diabetes mellitus
OT  - autoislet
OT  - chronic pancreatitis
OT  - islet transplant
OT  - pancreatitis
OT  - total pancreatectomy
COIS- Disclosures: The authors of this manuscript have no conflicts of interest to 
      disclose as described by the American Journal of Transplantation.
EDAT- 2013/08/09 06:00
MHDA- 2014/05/28 06:00
PMCR- 2014/10/01
CRDT- 2013/08/09 06:00
PHST- 2013/02/14 00:00 [received]
PHST- 2013/05/24 00:00 [revised]
PHST- 2013/06/13 00:00 [accepted]
PHST- 2013/08/09 06:00 [entrez]
PHST- 2013/08/09 06:00 [pubmed]
PHST- 2014/05/28 06:00 [medline]
PHST- 2014/10/01 00:00 [pmc-release]
AID - S1600-6135(22)26151-6 [pii]
AID - 10.1111/ajt.12392 [doi]
PST - ppublish
SO  - Am J Transplant. 2013 Oct;13(10):2664-71. doi: 10.1111/ajt.12392. Epub 2013 Aug 
      7.