title: Three-yr follow-up of a type 1 diabetes mellitus patient with an islet xenotransplant.
abstract: In order to alleviate the shortage of human donors, the use of porcine islets of Langerhans for xenotransplantation in diabetic patients has been proposed as a solution. To overcome rejection, we have developed a procedure for protecting the islets by combining them with Sertoli cells and placing them in a novel subcutaneous device, that generates an autologous collagen covering. A type 1 diabetic woman was closely monitored for 10 months, and then transplanted in two devices with two months of difference and a third time after 22 months. Here we present a three-yr follow-up. The close monitoring induced a rapid decrease in exogenous insulin requirements, which stabilized between 19 and 28 IU/d for nine months. After transplantation, the requirements reduced further to below 6 IU/d and for some weeks she was insulin free. Glycosylated hemoglobin levels decreased concomitantly. Porcine insulin could be detected in the serum after a glucose challenge and insulin positive cells inside a removed device after two yr. No complications have arisen and no porcine endogenous retrovirus infection has been detected through PCR and RT-PCR. This case demonstrates the feasibility of using the xenotransplantation of porcine cells to alleviate metabolic complications and insulin requirements in type 1 diabetic patients.
authors.affiliation: Department of Surgery, Faculty of Medicine, National Autonomous University of Mexico, Children's Hospital of Mexico, Federico Gomez, México City, Mexico. rvaldes@xenomexico.org
authors.forename: R A
authors.initials: RA
authors.lastname: Valdés-González
authors.forename: D J G
authors.initials: DJ
authors.lastname: White
authors.forename: L M
authors.initials: LM
authors.lastname: Dorantes
authors.forename: L
authors.initials: L
authors.lastname: Terán
authors.forename: G N
authors.initials: GN
authors.lastname: Garibay-Nieto
authors.forename: E
authors.initials: E
authors.lastname: Bracho-Blanchet
authors.forename: R
authors.initials: R
authors.lastname: Dávila-Pérez
authors.forename: L
authors.initials: L
authors.lastname: Evia-Viscarra
authors.forename: C E
authors.initials: CE
authors.lastname: Ormsby
authors.forename: J T
authors.initials: JT
authors.lastname: Ayala-Sumuano
authors.forename: M L
authors.initials: ML
authors.lastname: Silva-Torres
authors.forename: B
authors.initials: B
authors.lastname: Ramírez-González
mesh_terms: D000293:Adolescent; D000818:Animals; D054304:Anti-Mullerian Hormone; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D007328:Insulin / Q000008:administration & dosage; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D013552:Swine; D013735:Testicular Hormones / Q000032:analysis; D014183:Transplantation, Heterologous
chemical_list: D054304:Anti-Mullerian Hormone; D006442:Glycated Hemoglobin; D006023:Glycoproteins; D007328:Insulin; D013735:Testicular Hormones; C517652:hemoglobin A1c protein, human