title: Insulin independence of unstable diabetic patient after single living donor islet transplantation.
abstract: BACKGROUND
  Current success in islet transplantation will lead to a donor shortage. Living donor islet transplantation could be an alternative approach to expand the potential donor pool. In this study we describe the first successful living donor islet transplantation for unstable diabetes, performed at Kyoto University Hospital on January 19, 2005.
  
  
  METHODS
  The donor was a healthy 56-year-old woman and mother of the recipient. The recipient was a 27-year-old woman with insulin-dependent diabetes since the age of 15 years. She experienced frequent hypoglycemic unawareness episodes. Her blood glucose concentration was difficult to control and C-peptide level was negative after glucagon stimulation. She needed an average 28 of units of insulin per day. The donor underwent a distal pancreatectomy and islets were isolated from the resected pancreas graft. The total islet yield was 408,114 islet equivalents and isolated islets were immediately transplanted into the recipient's liver.
  
  
  RESULTS
  After transplant, the blood glucose level of the recipient was tightly controlled without hypoglycemic episodes. She was discharged on day 37 with a normal oral glucose tolerance test (OGTT). The recipient remained insulin-independent for >3 months, since day 22 posttransplant. The donor's postoperative clinical course was uneventful. She was discharged on postoperative day 18 and returned to her job within 1 month.
  
  
  CONCLUSIONS
  We report the first successful living donor islet transplantation for the treatment of unstable diabetes. We believe that living donor islet transplantation may become an option in the treatment of insulin-dependent diabetes.
authors.affiliation: Transplantation Unit, Kyoto University Hospital, 54 Kawara-cho Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. shinichi@kuhp.kyoto-u.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Matsumoto
authors.forename: T
authors.initials: T
authors.lastname: Okitsu
authors.forename: Y
authors.initials: Y
authors.lastname: Iwanaga
authors.forename: H
authors.initials: H
authors.lastname: Noguchi
authors.forename: H
authors.initials: H
authors.lastname: Nagata
authors.forename: Y
authors.initials: Y
authors.lastname: Yonekawa
authors.forename: Y
authors.initials: Y
authors.lastname: Yamada
authors.forename: Y
authors.initials: Y
authors.lastname: Nakai
authors.forename: M
authors.initials: M
authors.lastname: Ueda
authors.forename: A
authors.initials: A
authors.lastname: Ishii
authors.forename: E
authors.initials: E
authors.lastname: Yabunaka
authors.forename: J A
authors.initials: JA
authors.lastname: Shapiro
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D016381:Islets of Langerhans Transplantation / Q000379:methods / Q000502:physiology*; D019520:Living Donors; D008875:Middle Aged; D010180:Pancreatectomy; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007004:Hypoglycemic Agents; D007328:Insulin