title: Protection of encapsulated human islets implanted without immunosuppression in patients with type I or type II diabetes and in nondiabetic control subjects.
abstract: Human islets were macroencapsulated in permselective hollow fiber membrane devices and successfully allotransplanted subcutaneously with > 90% viability after 2 weeks in situ. Recipients were patients with type I or type II diabetes and normal control subjects; none was immunosuppressed. Between 150 and 200 islet equivalents were implanted in each of the nine patients. No adverse patient complications were observed. Biocompatibility of devices was excellent. Insulin-positive beta-cells were confirmed in encapsulated islets recovered from the implanted devices in all patient populations including the type I diabetic patients. Glucose-stimulated insulin release could be demonstrated in vitro from recovered islets. These data demonstrate that macroencapsulated human islets can survive at the subcutaneous site and that permselective membranes can be designed to protect against both allogeneic immune responses as well as the autoimmune component of type I diabetes.
authors.affiliation: Department of Surgery, Washington University, St. Louis, Missouri.
authors.forename: D W
authors.initials: DW
authors.lastname: Scharp
authors.forename: C J
authors.initials: CJ
authors.lastname: Swanson
authors.forename: B J
authors.initials: BJ
authors.lastname: Olack
authors.forename: P P
authors.initials: PP
authors.lastname: Latta
authors.forename: O D
authors.initials: OD
authors.lastname: Hegre
authors.forename: E J
authors.initials: EJ
authors.lastname: Doherty
authors.forename: F T
authors.initials: FT
authors.lastname: Gentile
authors.forename: K S
authors.initials: KS
authors.lastname: Flavin
authors.forename: M F
authors.initials: MF
authors.lastname: Ansara
authors.forename: P E
authors.initials: PE
authors.lastname: Lacy
mesh_terms: D001672:Biocompatible Materials; D001786:Blood Glucose / Q000378:metabolism; D002470:Cell Survival; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D005947:Glucose / Q000494:pharmacology; D006801:Humans; D007165:Immunosuppression Therapy; D007328:Insulin / Q000032:analysis / Q000378:metabolism*; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000166:cytology / Q000187:drug effects / Q000378:metabolism*; D016381:Islets of Langerhans Transplantation / Q000379:methods* / Q000502:physiology; D008567:Membranes, Artificial; D013806:Theophylline / Q000494:pharmacology
chemical_list: D001672:Biocompatible Materials; D001786:Blood Glucose; D007328:Insulin; D008567:Membranes, Artificial; D013806:Theophylline; D005947:Glucose