title: Clinical islet transplantation in Japan.
abstract: BACKGROUND
  The results of clinical islet transplantation in Japan are, here in, reported and discussed its efficacy and problems.
  
  
  METHODS
  Since the first islet transplantation was performed in 2004, 65 islet isolations and 34 islet transplantations to 18 type 1 diabetic patients have been performed in Japan.
  
  
  RESULTS
  Following islet transplantation, patients experienced decreased insulin requirements and lower hemoglobin A1C levels, and positive serum C-peptide levels. All patients achieved stabilized blood glucose levels and the disappearance of hypoglycemic unawareness. Although three patients achieved insulin independency for a limited period, persistent islet graft function was difficult to maintain. Overall islet graft survival was 86.5% at 6 months, 78.7% at 1 year, and 62.9% at 2 years after the first islet transplantation. In our institution, we carried out 23 islet isolations and six islet transplantations to four patients. Although insulin independency was not achieved, all patients showed a disappearance of hypoglycemic unawareness.
  
  
  CONCLUSIONS
  Using data from the Japanese Trial of Islet Transplantation, the effectiveness of islet transplantation was shown even when using the pancreata from non-heart-beating donors. Although there are a number of problems to be solved and further improvement is needed, we can state that the introduction of clinical islet transplantation offers hope for type 1 diabetic patients.
authors.affiliation: Department of Surgery, Chiba-East National Hospital, National Hospital Organization, Chiba City, Chiba, Japan. kenmoti@cehprinet.com
authors.forename: Takashi
authors.initials: T
authors.lastname: Kenmochi
authors.forename: Takehide
authors.initials: T
authors.lastname: Asano
authors.forename: Michihiro
authors.initials: M
authors.lastname: Maruyama
authors.forename: Kenichi
authors.initials: K
authors.lastname: Saigo
authors.forename: Naotake
authors.initials: N
authors.lastname: Akutsu
authors.forename: Chikara
authors.initials: C
authors.lastname: Iwashita
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ohtsuki
authors.forename: Taihei
authors.initials: T
authors.lastname: Ito
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002096:C-Peptide / Q000097:blood; D002102:Cadaver; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D014019:Tissue Donors
chemical_list: D002096:C-Peptide