Clinical Islet Transplant Program, Department of Medicine, University of Alberta and Alberta Health Services, Edmonton, AB, Canada.
Institute of Biomedical and Clinical Science, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom.
Transpl Int. 2022 Jul 6;35:10335. doi: 10.3389/ti.2022.10335. eCollection 2022.
Little is known about how early islet graft function evolves in the clinical setting. The BETA-2 score is a validated index of islet function that can be calculated from a single blood sample and lends itself to frequent monitoring of graft function. In this study, we characterized early graft function by calculating weekly BETA-2 score in recipients who achieved insulin independence after single transplant (group 1, = 8) compared to recipients who required a second transplant before achieving insulin independence (group 2, = 7). We also determined whether graft function 1-week post-transplant was associated with insulin independence in individuals who received initial transplant between 2000-2017 ( = 125). Our results show that graft function increased rapidly reaching a plateau 4-6 weeks post-transplant. The BETA-2 score was higher in group 1 compared to group 2 as early as 1-week post-transplant (15 + 3 vs. 9 + 2, = 0.001). In an unselected cohort, BETA-2 at 1-week post-transplant was associated with graft survival as defined by insulin independence during median follow up of 12 months (range 2-119 months) with greater survival among those with BETA-2 score >10 ( < 0.001, log-rank test). These findings suggest that primary graft function is established within 4-6 weeks post-transplant and graft function at 1-week post-transplant predicts long-term transplant outcomes.
关于胰岛移植物在临床环境中的早期功能演变，人们知之甚少。BETA-2 评分是一种经过验证的胰岛功能指数，可以从单个血样中计算得出，并且适合频繁监测移植物功能。在这项研究中，我们通过计算单移植后实现胰岛素独立性的受者（组 1， = 8）和需要第二次移植才能实现胰岛素独立性的受者（组 2， = 7）每周的 BETA-2 评分，来描述早期移植物功能。我们还确定了在 2000-2017 年间接受初始移植的个体中，移植后 1 周的移植物功能是否与胰岛素独立性相关（ = 125）。我们的研究结果表明，移植物功能迅速增加，在移植后 4-6 周达到平台期。移植后 1 周时，组 1 的 BETA-2 评分高于组 2（15 + 3 vs. 9 + 2， = 0.001）。在一个未选择的队列中，移植后 1 周的 BETA-2 与胰岛素独立性定义的移植物存活相关，中位随访 12 个月（范围 2-119 个月）期间，BETA-2 评分 >10 的患者具有更好的存活率（ < 0.001，对数秩检验）。这些发现表明，主要移植物功能在移植后 4-6 周内建立，并且移植后 1 周的移植物功能预测长期移植结果。
