Enumerating β-Cells in Whole Human Islets: Sex Differences and Associations With Clinical Outcomes After Islet Transplantation

Islet transplantation is an experimental therapy for type 1 diabetes. Though it is increasingly successful, limitations include unpredictable declines in islet graft function (1). There is still inadequate knowledge of specific human islet characteristics that predispose to successful and durable islet graft function and what types of donors are more likely to have islets with these beneficial traits. The relationship between the composition of dissociated human islets (as opposed to whole islets) and transplant outcomes has been studied (2), with a positive association between recipients’ acute insulin response to glucose (AIRg) posttransplant and number of pancreatic ductal cells in the preparation (a positive association with number of β-cells approached significance). However, as dissociation inherently damages islets, β-cells enumerated after dissociation may no longer reflect the number of β-cells within whole islets ultimately transplanted. Using an epidemiological approach, we therefore investigated 1 ) the independent association of the β-cell composition of transplanted whole human islets with recipient outcomes and 2 ) the donor …