[Technique of pancreatic procurement for pancreatic islet isolation].
OBJECTIVE
The allograft of pancreatic islets represents a potential alternative to insulin therapy in patients suffering from the most severe forms of Type 1 diabetes. Here we report our experience of pancreatic procurement for isolation and islet allograft.


METHODS
Pancreata were procured in brain-dead donors. The islets were isolated using techniques developed and validated in pigs and men. Injection of a given preparation was decided after quantitative and qualitative controls. Islets were transplanted in Type 1 diabetic patients already grafted with a kidney or suffering from severe and/or unstable diabetes, after percutaneous or surgical settlement of an intra-portal catheter. Patients received an "Edmonton-like" immunosuppressive protocol. Grafts were repeated once or twice until a total quantity of 10,000 transplanted islet-equivalents was obtained.


RESULTS
Twenty-nine pancreata were procured and 14 preparations were grafted to 7 patients. Eleven graftings were done percutaneously and three were surgical. The initial function of the 14 transplants was confirmed by secretion of C-peptide and decrease of insulin doses. Insulin therapy was completely interrupted in the 5 patients having received at least two grafts.


CONCLUSIONS
These preliminary clinical results confirmed that the isolation technique of human islets and the technique of pancreas procurement are mastered by our team. If the results of this assay (assessment one year after graft) confirm our hopes, we will be able to offer islet allografts to an increasing number of patients with severe Type 1 diabetes.
Hubert
T
T
Equipe INSERM ERIT-M 0106 thérapie cellulaire du diabète, faculté de médecine, pôle recherche, centre hospitalier régional et universitaire de Lille, 59045 Lille cedex, France.
Arnalsteen
L
L
Jany
T
T
Prieur
E
E
Triponez
F
F
Nunes
B
B
Vantyghem
M-C
MC
Gmyr
V
V
Kerr-Conte
J
J
Proye
C
C
Pattou
F
F
D000818:Animals; D001926:Brain Death; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D016035:Pancreas Transplantation / Q000379:methods*; D013552:Swine; D009927:Tissue and Organ Procurement / Q000379:methods*; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents