Islet Product Characteristics and Factors Related to Successful Human Islet Transplantation From the Collaborative Islet Transplant Registry (CITR) 1999-2010

Publication Type
Journal Article
Year of Publication
2014
Authors
Balamurugan, A; Naziruddin, B; Lockridge, A; Tiwari, M; Loganathan, G; Takita, M; Matsumoto, S; Papas, K; Trieger, M; Rainis, H; Kin, T; Kay,T; Wease, S; Messinger, S; [...]; Maffi, P; Secchi, A; Berney, T; O'Connell, P; Hering, B; Barton, FB
Secondary
Am J Transplant
Volume
14
Start Page
2595
Pagination
2595-2606
Date Published
11/2014
Keywords
Clinical research/practice; diabetes; diabetes type 1; endocrinology/diabetology; health services and outcomes research; islet isolation; islet transplantation; Organ Procurement and Transplantation Network (OPTN); pancreas
Abstract
The Collaborative Islet Transplant Registry (CITR) collects data on clinical islet isolations and transplants. This retrospective report analyzed 1017 islet isolation procedures performed for 537 recipients of allogeneic clinical islet transplantation in 1999-2010. This study describes changes in donor and islet isolation variables by era and factors associated with quantity and quality of final islet products. Donor body weight and BMI increased significantly over the period (p < 0.001). Islet yield measures have improved with time including islet equivalent (IEQ)/particle ratio and IEQs infused. The average dose of islets infused significantly increased in the era of 2007-2010 when compared to 1999-2002 (445.4 +/- 156.8 vs. 421.3 +/- 155.4 x10(3) IEQ; p < 0.05). Islet purity and total number of beta cells significantly improved over the study period (p < 0.01 and <0.05, respectively). Otherwise, the quality of clinical islets has remained consistently very high through this period, and differs substantially from nonclinical islets. In multivariate analysis of all recipient, donor and islet factors, and medical management factors, the only islet product characteristic that correlated with clinical outcomes was total IEQs infused. This analysis shows improvements in both quantity and some quality criteria of clinical islets produced over 1999-2010, and these parallel improvements in clinical outcomes over the same period.