Matsumoto S, Yamada Y, Okitsu T, Iwanaga Y, Noguchi H, Nagata H, Yonekawa Y, Nakai Y, Ueda M, Ishii A, Yabunaka E, Tanaka K
Transplantation Unit, Kyoto University Hospital, 54 Kawara-cho Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Transplant Proc. 2005 Oct;37(8):3435-7. doi: 10.1016/j.transproceed.2005.09.045.
Evaluation of engraftment is important to assess the success of islet transplantation. Recently we developed secretory unit of islet transplant objects (SUITO) index for simple evaluation of engraftment. Assuming that normal subjects aged <40 years have 100% pancreatic beta-cell function, SUITO index was calculated by the formula: 1500 x fasting C-peptide immunoreactivity [ng/dL]/(fasting blood glucose [mg/dL] - 63). In this study, we compared the efficacy of islet transplantation from cadaveric and living donors using the SUITO index.
We performed eight islet transplantations with non-heart-beating donors (NHBDs) into five patients. Two patients received fresh islets once, one patient received fresh islets twice, one patient received cultured islets once, and one patient received cultured islets twice plus fresh islets once. In addition, one patient received fresh islets from a living donor. We calculated the SUITO index from postoperative days 3 to 30 for each case.
Mean SUITO index after one fresh islet transplant was 11.7 +/- 1.0, after two fresh islet transplants was 28.5 +/- 3.4, after one cultured islet transplant was 2.1 +/- 0.4, after two cultured islet transplant was 12.1 +/- 1.9, and after two cultured islet transplant plus one fresh islet transplant was 26.7 +/- 1.7. The mean SUITO index after single living donor islet transplant was 40.7 +/- 2.6, which was significantly higher compared with all other groups. Insulin independence was obtained when the SUITO index was >26, which might reflect that 26% beta-cell mass was required for insulin independence.
SUITO index is useful to evaluate islet engraftment and to predict the possibility of insulin independence.
评估胰岛移植的植入情况对于评估胰岛移植的成功与否至关重要。最近我们开发了胰岛移植对象分泌单位（SUITO）指数，用于简单评估植入情况。假设年龄<40岁的正常受试者胰腺β细胞功能为100%，SUITO指数通过以下公式计算：1500×空腹C肽免疫反应性[ng/dL]/（空腹血糖[mg/dL] - 63）。在本研究中，我们使用SUITO指数比较了来自尸体供体和活体供体的胰岛移植效果。
我们对5例患者进行了8次非心脏跳动供体（NHBDs）胰岛移植。2例患者接受了1次新鲜胰岛移植，1例患者接受了2次新鲜胰岛移植，1例患者接受了1次培养胰岛移植，1例患者接受了2次培养胰岛移植加1次新鲜胰岛移植。此外，1例患者接受了来自活体供体的新鲜胰岛移植。我们计算了每个病例术后第3天至第30天的SUITO指数。
1次新鲜胰岛移植后的平均SUITO指数为11.7±1.0，2次新鲜胰岛移植后为28.5±3.4，1次培养胰岛移植后为2.1±0.4，2次培养胰岛移植后为12.1±1.9，2次培养胰岛移植加1次新鲜胰岛移植后为26.7±1.7。单次活体供体胰岛移植后的平均SUITO指数为40.7±2.6，与所有其他组相比显著更高。当SUITO指数>26时可实现胰岛素非依赖，这可能反映胰岛素非依赖需要26%的β细胞量。
SUITO指数有助于评估胰岛植入情况并预测胰岛素非依赖的可能性。
