Wang Ling-Jia, Kin Tatsuya, O'Gorman Doug, Shapiro A M James, Naziruddin Bashoo, Takita Morihito, Levy Marlon F, Posselt Andrew M, Szot Gregory L, Savari Omid, Barbaro Barbara, McGarrigle James, Yeh Chun Chieh, Oberholzer Jose, Lei Ji, Chen Tao, Lian Moh, Markmann James F, Alvarez Alejandro, Linetsky Elina, Ricordi Camillo, Balamurugan A N, Loganathan Gopalakrishnan, Wilhelm Joshua J, Hering Bernhard J, Bottino Rita, Trucco Massimo, Liu Chengyang, Min Zaw, Li Yanjing, Naji Ali, Fernandez Luis A, Ziemelis Martynas, Danobeitia Juan S, Millis J Michael, Witkowski Piotr
Department of Surgery, Section of Transplantation, University of Chicago, Chicago, IL.
Clinical Islet Transplant Program, University of Alberta and Alberta Health Services, Edmonton, Alberta, Canada.
Cell Transplant. 2016;25(8):1515-1523. doi: 10.3727/096368916X691141. Epub 2016 Feb 26.
Selection of an optimal donor pancreas is the first key task for successful islet isolation. We conducted a retrospective multicenter study in 11 centers in North America to develop an islet donor scoring system using donor variables. The data set consisting of 1,056 deceased donors was used for development of a scoring system to predict islet isolation success (defined as postpurification islet yield >400,000 islet equivalents). With the aid of univariate logistic regression analyses, we developed the North American Islet Donor Score (NAIDS) ranging from 0 to 100 points. The c index in the development cohort was 0.73 (95% confidence interval 0.70-0.76). The success rate increased proportionally as the NAIDS increased, from 6.8% success in the NAIDS < 50 points to 53.7% success in the NAIDS ≥ 80 points. We further validated the NAIDS using a separate set of data consisting of 179 islet isolations. A comparable outcome of the NAIDS was observed in the validation cohort. The NAIDS may be a useful tool for donor pancreas selection in clinical practice. Apart from its utility in clinical decision making, the NAIDS may also be used in a research setting as a standardized measurement of pancreas quality.
选择最佳供体胰腺是成功进行胰岛分离的首要关键任务。我们在北美11个中心开展了一项回顾性多中心研究，以利用供体变量开发一种胰岛供体评分系统。由1056名已故供体组成的数据集被用于开发一个评分系统，以预测胰岛分离的成功率（定义为纯化后胰岛产量>40万胰岛当量）。借助单因素逻辑回归分析，我们开发了北美胰岛供体评分（NAIDS），范围为0至100分。开发队列中的c指数为0.73（95%置信区间0.70 - 0.76）。随着NAIDS的增加，成功率成比例提高，从NAIDS < 50分的6.8%成功率提高到NAIDS≥80分的53.7%成功率。我们使用由179次胰岛分离组成的另一组数据进一步验证了NAIDS。在验证队列中观察到了NAIDS的类似结果。NAIDS可能是临床实践中选择供体胰腺的有用工具。除了在临床决策中的实用性外，NAIDS还可在研究环境中用作胰腺质量的标准化测量指标。
