The UK islet allotransplant program is nationally funded to deliver one or two transplants over 12 months to individuals with type 1 diabetes and recurrent severe hypoglycemia. Analyses were undertaken 10 years after program inception to evaluate associations between transplanted mass; single versus two transplants; time between two transplants and graft survival (stimulated C-peptide >50 pmol/L) and function. In total, 84 islet transplant recipients were studied. Uninterrupted graft survival over 12 months was attained in 23 (68%) single and 47 (94%) (p = .002) two transplant recipients (separated by [median (IQR)] 6 (3–8) months). 64% recipients of one or two transplants with uninterrupted function at 12 months sustained graft function at 6 years. Total transplanted mass was associated with Mixed Meal Tolerance Test stimulated C-peptide at 12 months (p < .01). Despite 1.9-fold greater transplanted mass in recipients of two versus one islet infusion (12 218 [9291–15 417] vs. 6442 [5156–7639] IEQ/kg; p < .0001), stimulated C-peptide was not significantly higher. Shorter time between transplants was associated with greater insulin dose reduction at 12 months (beta −0.35; p = .02). Graft survival over the first 12 months was greater in recipients of two versus one islet transplant in the UK program, although function at 1 and 6 years was comparable. Minimizing the interval between 2 islet infusions may maximize cumulative impact on graft function.

中文翻译：

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国家胰岛移植计划中胰岛质量、移植次数和移植间隔时间对移植物功能的影响


英国胰岛同种异体移植计划由国家资助，在 12 个月内为患有 1 型糖尿病和复发性严重低血糖的患者提供一到两次移植手术。项目启动 10 年后进行了分析，以评估移植肿块之间的关联；单次移植与两次移植；两次移植之间的时间以及移植物存活（刺激的 C 肽 >50 pmol/L）和功能。总共对 84 名胰岛移植受者进行了研究。 23 (68%) 名单一移植受者和 47 (94%) ( p = .002) 名两名移植受者（相隔 [中位 (IQR)] 6 (3-8) 个月）获得了超过 12 个月的不间断移植物存活。 64% 接受一两次移植的患者在 12 个月时功能不间断，并在 6 岁时维持移植功能。总移植质量与 12 个月时混合膳食耐受性测试刺激的 C 肽相关（ p < .01）。尽管两种胰岛输注的受者的移植质量比一种胰岛输注的受者高出 1.9 倍（12 218 [9291–15 417] vs. 6442 [5156–7639] IEQ/kg； p < .0001），但刺激后的 C 肽并未显着升高。移植间隔时间越短与 12 个月时胰岛素剂量减少幅度越大相关（β -0.35； p = .02）。在英国项目中，接受两次胰岛移植的受者在前 12 个月内的移植物存活率高于接受一次胰岛移植的受者，尽管 1 年和 6 年的功能相当。最小化两次胰岛输注之间的间隔可以最大程度地提高对移植物功能的累积影响。