title: Follow-up study of the first successful living donor islet transplantation.
abstract: BACKGROUND
  Islet transplantation has become an option for the treatment of insulin-dependent diabetes mellitus and is usually performed using brain-dead heartbeating donors. However, we have very limited number of such donors in Japan; therefore, it is not allowed to perform islet transplantation with brain-dead donors. In order to perform islet transplantation in Japan, we need to seek new donor resources.
  
  
  METHODS
  We performed the first successful living-donor islet transplantation. In this case, the recipient had brittle diabetes with hypoglycemic unawareness. The donor was deemed qualified after undergoing both metabolic and preoperative assessments. Distal pancreatectomy was performed using open laparotomy and more than 400,000 islets were isolated and transplanted immediately.
  
  
  RESULTS
  The recipient has been insulin independent posttransplant with positive C-peptide for more than one year. She no longer suffers from hypoglycemic unawareness and displayed a substantial improvement in hemoglobulin (Hb) A1C. The donor's clinical course was uneventful, which allowed her to return to her job within one month. She maintained normal fasting C-peptide and HbA1C levels during follow-up period.
  
  
  CONCLUSIONS
  In our first case of living donor islet transplantation, both the donor and the recipient have been maintaining excellent glycemic control with no untreatable complications for more than one year.
authors.affiliation: 2nd Department of Surgery, Fujita Health University, Aichi, Japan. shinichi41@mac.com
authors.forename: Shinichi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Teru
authors.initials: T
authors.lastname: Okitsu
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Iwanaga
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Noguchi
authors.forename: Hideo
authors.initials: H
authors.lastname: Nagata
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Yonekawa
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Liu
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kamiya
authors.forename: Michiko
authors.initials: M
authors.lastname: Ueda
authors.forename: Nobuyo
authors.initials: N
authors.lastname: Hatanaka
authors.forename: Naoya
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yamada
authors.forename: Shuichi
authors.initials: S
authors.lastname: Miyakawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Seino
authors.forename: A M James
authors.initials: AM
authors.lastname: Shapiro
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D046148:Donor Selection; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016381:Islets of Langerhans Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome