Clinical islet transplantation in Japan.
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.
Kenmochi
Takashi
T
Department of Surgery, Chiba-East National Hospital, National Hospital Organization, Chiba City, Chiba, Japan. kenmoti@cehprinet.com
Asano
Takehide
T
Maruyama
Michihiro
M
Saigo
Kenichi
K
Akutsu
Naotake
N
Iwashita
Chikara
C
Ohtsuki
Kazunori
K
Ito
Taihei
T
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
D002096:C-Peptide