title: Islets isolated from donors with elevated HbA1c can be successfully transplanted.
abstract: Clinical islet transplantation is limited by the availability of donor organs. We report two cases where islets were isolated from donors with elevated HbA1c (6.3% and 7.9%). Islet isolation yield was adequate in both cases (521,350 and 497,472 islet equivalents, respectively). Islet graft analyses revealed a decreased proportion of beta cells (21.6%) and an increase in alpha cells (51.0%) in the donor with the higher HbA1c, although graft characteristics of the other donor were similar to donors with normal HbA1c. Both islet preparations were transplanted into type 1 diabetes recipients with brittle diabetes. One recipient has remained insulin independent for 4 years to date with good glycemic control. The other recipient who received islets from the donor with the higher HbA1c had a 56% reduction in insulin requirement after transplant. Pancreases from donors with mild hyperglycemia may be a source of islets that could be considered for clinical islet transplantation.
authors.affiliation: Clinical Islet Transplant Program, University of Alberta, Edmonton, AB, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Koh
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kin
authors.forename: Sharleen
authors.initials: S
authors.lastname: Imes
authors.forename: A M James
authors.initials: AM
authors.lastname: Shapiro
authors.forename: Peter
authors.initials: P
authors.lastname: Senior
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D017809:Fatal Outcome; D005947:Glucose / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000096:biosynthesis*; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000473:pathology; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D005947:Glucose; D006442:Glycated Hemoglobin