Long-term graft function after allogeneic islet transplantation.
Islet transplants are emerging as a viable option for the treatment of type 1 diabetes mellitus. From 1989 to 1995 we conducted a series of simultaneous islet-kidney transplants in six uremic type 1 diabetic patients. We report two of these patients who have shown persistent islet graft function over many years. Two female patients with duration of diabetes of 27 and 37 years underwent simultaneous islet-kidney transplant under steroid- and cyclosporine-based immunosuppression. Freshly isolated islets were supplemented with cryopreserved islets from our low-temperature bank of frozen islets. A total islet mass of 9,866 and 15,061 islet equivalents/kg body weight, respectively, was transplanted into the liver through portal vein. Reasonable blood glucose control has been achieved for up to 6 years posttransplant in one patient, but there was minimum clinical benefit from the islet graft at 10 years. In contrast, sustained insulin secretion with nearly normal HbA1c at 13 years follow-up was observed in another patient, providing hope for improving long-term graft outcomes for islet transplant recipient.
Clinical Islet Transplant Program, University of Alberta and Capital Health Authority, Edmonton, Alberta, Canada. Jonlakey@rogers.blackberry.net
Jonathan R T
JR
Lakey
Tatsuya
T
Kin
Garth L
GL
Warnock
A M James
AM
Shapiro
Panagiotis
P
Tsapogas
Sharleen
S
Imes
Gregory S
GS
Korbutt
Norman M
NM
Kneteman
Ray V
RV
Rajotte
Edmond A
EA
Ryan
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016572:Cyclosporine / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D016381:Islets of Langerhans Transplantation; D016030:Kidney Transplantation; D015122:Mercaptopurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D014184:Transplantation, Homologous
D001786:Blood Glucose; D007166:Immunosuppressive Agents; D007328:Insulin; C488629:azathiopurine; D016572:Cyclosporine; D015122:Mercaptopurine; D011241:Prednisone