title: Human islet isolation and allotransplantation in 22 consecutive cases.
abstract: This report provides our initial experience in islet isolation and intrahepatic allotransplantation in 21 patients. In group 1, 10 patients underwent combined liver-islet allotransplantation following upper-abdominal exenteration for cancer. In group 2, 4 patients received a combined liver-islet allograft for cirrhosis and diabetes. One patients had plasma C-peptide greater than 3 pM and was therefore excluded from analysis. In group 3, 7 patients received 8 combined cadaveric kidney-islet grafts (one retransplant) for end-stage renal disease secondary to type 1 diabetes mellitus. The islets were separated by a modification of the automated method for human islet isolation and the preparation were infused into the portal vein. Immunosuppression was with FK506 (group 1) plus steroids (groups 2 and 3). Six patients in group 1 did not require insulin treatment for 5 to greater than 16 months. In groups 2 and 3 none of the patients became insulin-independent, although decreased insulin requirement and stabilization of diabetes were observed. Our results indicate that rejection is still a major factor limiting the clinical application of islet transplantation in patients with type 1 diabetes mellitus, although other factors such as steroid treatment may contribute to deteriorate islet engraftment and/or function.
authors.affiliation: University of Pittsburgh, Transplant Institute, Pennsylvania 15213.
authors.forename: C
authors.initials: C
authors.lastname: Ricordi
authors.forename: A G
authors.initials: AG
authors.lastname: Tzakis
authors.forename: P B
authors.initials: PB
authors.lastname: Carroll
authors.forename: Y J
authors.initials: YJ
authors.lastname: Zeng
authors.forename: H L
authors.initials: HL
authors.lastname: Rilo
authors.forename: R
authors.initials: R
authors.lastname: Alejandro
authors.forename: A
authors.initials: A
authors.lastname: Shapiro
authors.forename: J J
authors.initials: JJ
authors.lastname: Fung
authors.forename: A J
authors.initials: AJ
authors.lastname: Demetris
authors.forename: D H
authors.initials: DH
authors.lastname: Mintz
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality / Q000601:surgery; D005260:Female; D006085:Graft Survival; D006801:Humans; D007515:Islets of Langerhans / Q000502:physiology; D016381:Islets of Langerhans Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation; D015996:Survival Rate; D014184:Transplantation, Homologous