[Transplantation of islets of Langerhans in man].
Islet of Langerhans transplantation is an alternative to whole pancreas transplantation for type I diabetic patients, in whom exogenous insulin therapy has not prevented the occurrence of systemic complications. Thanks to a new isolation technique of human islets, 45 patients have been transplanted worldwide since 1988, of whom only 7 have become totally insulin-independent. Rejection and quality of the islet preparations are problems which remain to be solved. Autotransplantation of islets has been proposed in patients undergoing a pancreatectomy for benign disease. The present report concerns two of our patients who had a pancreatectomy with islet autotransplantation. Both patients are insulin-independent 3 and 11 months postoperatively, with satisfactory metabolic tests. Islet autotransplantation can be proposed when pancreatectomy for non-malignant disease is performed. This method may prevent the development of insulin-dependent diabetes, known to be particularly labile. Because of the sophisticated technical procedures required, human islet isolation is at present only performed in a small number of medical centers and still is in the field of medical experimentation.
Département de chirurgie, Hôpital cantonal universitaire de Genève.
P H
PH
Morel
L
L
Bühler
M
M
Marini
S
S
Deng
R
R
Mage
G
G
Mentha
A
A
Rohner
D000328:Adult; D002908:Chronic Disease; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010195:Pancreatitis / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D014182:Transplantation, Autologous