Living donor islet transplantation, the alternative approach to overcome the obstacles limiting transplant.
We performed the world's first successful living donor islet transplantation for unstable diabetes. A total of 408,114 islet equivalents were isolated from half a living pancreas and transplanted immediately to the recipient who was a 27-year-old female. The donor was a 56-year-old female in good health, mother of the recipient. The islets functioned immediately, and the recipient was weaned completely from insulin on the 22nd posttransplant day, and has maintained excellent glycemic control since. The donor was discharged on the 18th postoperative day with normal oral glucose tolerance test and without complications. Living donor islet transplantation could cure one insulin-dependent diabetes mellitus patients with a single donor. There are some advantages in the living donor islet transplantation: (a) living donor can alleviate the issue of donor shortage; (b) highly potent islets can be isolated from a living donor; and (c) the recipient can be treated with immunosuppressant and controlled blood glucose level tightly prior to the transplantation. These are important factors in overcoming the obstacles limiting islet transplantation. We believe that the living donor islet transplantation may become an additional option in treating insulin-dependent diabetes.
Iwanaga
Yasuhiro
Y
Department of Transplantation and Immunology, Kyoto University Graduate School of Medicine, 54 Kawara-cho Shogoin, Sakyo-ku, Kyoto, Japan 606-8507. iwanaga@kuhp.kyoto-u.ac.jp
Matsumoto
Shinichi
S
Okitsu
Teru
T
Noguchi
Hirofumi
H
Nagata
Hideo
H
Yonekawa
Yukihide
Y
Yamada
Yuichiro
Y
Fukuda
Kazuhito
K
Tsukiyama
Katsushi
K
Tanaka
Koichi
K
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D000077552:Basiliximab; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000069285:Infliximab; D007328:Insulin / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation; D019520:Living Donors; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D020123:Sirolimus / Q000008:administration & dosage / Q000627:therapeutic use; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D000077552:Basiliximab; D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069285:Infliximab; D007328:Insulin; D011993:Recombinant Fusion Proteins; D020123:Sirolimus; D016559:Tacrolimus