title: Human islet transplantation network for the treatment of Type I diabetes: first data from the Swiss-French GRAGIL consortium (1999-2000). Groupe de Recherche Rhin Rhĵne Alpes Genève pour la transplantation d'Ilots de Langerhans.
abstract: OBJECTIVE
  Improvements in islet transplantation require clinical series large enough to implement controlled new strategies. The goal of this study was to demonstrate the feasibility of a multicentre network for islet transplantation in Type I (insulin-dependent) diabetic patients.
  
  
  METHODS
  The five centres (Besançon, Geneva, Grenoble, Lyon, Strasbourg) of the GRAGIL network allow pancreas procurement, recipient recruitment, transplantation procedure and follow-up. Islet isolation is, however, performed in one single laboratory (Geneva). Pancreata were procured in each of the five centres and transported to Geneva with an ischaemia time of less than 8 hours. Islets were isolated using a standard automated method. If the islet number was too low for a graft (< 6,000 Islet-equivalent/kg), islets were cultured up to 12 days until another isolation was possible. Islets were transplanted by percutaneous transhepatic intraportal injection. Immunosuppression consisted of cyclosporine, mycophenolate mofetil, steroids and an anti-interleukin 2 receptor antibody.
  
  
  RESULTS
  From March 1999 to June 2000, 56 pancreata procurements were performed with an average yield of 234500 islet-equivalent, with 32 preparations over 200000 islet-equivalent. Ten C-peptide negative Type I diabetic patients (5 men and 5 women, median age 44 years, median diabetes duration 29 years) with an established kidney graft (> 6 months) received 9,030 +/- 1,090 islet-equivalent/kg with a median purity of 63 %. The number of pancreata required for each graft was 1 (n = 5) or 2 (n = 5). At the completion of a 12 month follow-up, we observed 0% primary nonfunction, 50% graft survival and 20% insulin-independence.
  
  
  CONCLUSIONS
  This study demonstrates the interest and the feasibility of a multicentre collaboration in human islet transplantation.
authors.affiliation: Department of Endocrinology, University Hospital, Grenoble, France. benhamou@ujf-grenoble.fr
authors.forename: P Y
authors.initials: PY
authors.lastname: Benhamou
authors.forename: J
authors.initials: J
authors.lastname: Oberholzer
authors.forename: C
authors.initials: C
authors.lastname: Toso
authors.forename: L
authors.initials: L
authors.lastname: Kessler
authors.forename: A
authors.initials: A
authors.lastname: Penfornis
authors.forename: F
authors.initials: F
authors.lastname: Bayle
authors.forename: C
authors.initials: C
authors.lastname: Thivolet
authors.forename: X
authors.initials: X
authors.lastname: Martin
authors.forename: F
authors.initials: F
authors.lastname: Ris
authors.forename: L
authors.initials: L
authors.lastname: Badet
authors.forename: C
authors.initials: C
authors.lastname: Colin
authors.forename: P
authors.initials: P
authors.lastname: Morel
mesh_terms: D000328:Adult; D017668:Age of Onset; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000502:physiology* / Q000706:statistics & numerical data; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D009927:Tissue and Organ Procurement / Q000379:methods; D016896:Treatment Outcome
chemical_list: D002096:C-Peptide