title: Insulin independence following isolated islet transplantation and single islet infusions.
abstract: OBJECTIVE
  To restore islet function in patients whose labile diabetes subjected them to frequent dangerous episodes of hypoglycemic unawareness, and to determine whether multiple transplants are always required to achieve insulin independence.
  
  
  BACKGROUND
  The recent report by the Edmonton group documenting restoration of insulin independence by islet transplantation in seven consecutive patients with type 1 diabetes differed from previous worldwide experience of only sporadic success. In the Edmonton patients, the transplanted islet mass critical for success was approximately more than 9,000 IEq/kg of recipient body weight and required two or three separate transplants of islets isolated from two to four cadaveric donors. Whether the success of the Edmonton group can be recapitulated by others, and whether repeated transplants using multiple donors will be a universal requirement for success have not been reported.
  
  
  METHODS
  The authors report their treatment with islet transplantation of nine patients whose labile type 1 diabetes was characterized by frequent episodes of dangerous hypoglycemia.
  
  
  RESULTS
  In each of the seven patients who have completed the treatment protocol (i.e., one or if necessary a second islet transplant), insulin independence has been achieved. In five of the seven patients only a single infusion of islets was required. To date, only one recipient has subsequently lost graft function, after an initially successful transplant. This patient suffered recurrent hyperglycemia 9 months after the transplant.
  
  
  CONCLUSIONS
  This report confirms the efficacy of the Edmonton immunosuppressive regimen and indicates that insulin independence can often be achieved by a single transplant of sufficient islet mass.
authors.affiliation: Department of Surgery, University of Pennsylvania Health System, Hospital of the University of Pennsylvania, 4th Floor Silverstein, 3400 Spruce Street, Philadelphia, PA 19104, USA. james.markmann@uphs.upenn.edu
authors.forename: James F
authors.initials: JF
authors.lastname: Markmann
authors.forename: Shaoping
authors.initials: S
authors.lastname: Deng
authors.forename: Xiaolun
authors.initials: X
authors.lastname: Huang
authors.forename: Niraj M
authors.initials: NM
authors.lastname: Desai
authors.forename: Ergun H
authors.initials: EH
authors.lastname: Velidedeoglu
authors.forename: Chengyang
authors.initials: C
authors.lastname: Lui
authors.forename: Adam
authors.initials: A
authors.lastname: Frank
authors.forename: Eileen
authors.initials: E
authors.lastname: Markmann
authors.forename: Maral
authors.initials: M
authors.lastname: Palanjian
authors.forename: Kenneth
authors.initials: K
authors.lastname: Brayman
authors.forename: Bryan
authors.initials: B
authors.lastname: Wolf
authors.forename: Ewan
authors.initials: E
authors.lastname: Bell
authors.forename: Marko
authors.initials: M
authors.lastname: Vitamaniuk
authors.forename: Nicolai
authors.initials: N
authors.lastname: Doliba
authors.forename: Franz
authors.initials: F
authors.lastname: Matschinsky
authors.forename: Clyde F
authors.initials: CF
authors.lastname: Barker
authors.forename: Ali
authors.initials: A
authors.lastname: Naji
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation / Q000276:immunology / Q000379:methods; D020127:Recovery of Function
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007166:Immunosuppressive Agents