AUTHOR=Lam Anna , Oram Richard A. , Forbes Shareen , Olateju Tolu , Malcolm Andrew J. , Imes Sharleen , Shapiro A. M. James , Senior Peter A. 

TITLE=Estimation of Early Graft Function Using the BETA-2 Score Following Clinical Islet Transplantation

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10335

DOI=10.3389/ti.2022.10335

ISSN=1432-2277

ABSTRACT=Background: 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. Methods: We characterized early graft function by calculating weekly BETA-2 score in recipients who achieved insulin independence after single transplant (group 1, n=8) compared to recipients who required a second transplant before achieving insulin independence (group 2, n=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 (n=125). Results: 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, P=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 (P<0.001, log-rank test). Conclusion: Primary graft function is established within 4-6 weeks post-transplant and graft function at 1-week post-transplant predicts long-term transplant outcomes.