Safety and viability of microencapsulated human islets transplanted into diabetic humans.
OBJECTIVE
Transplantation of insulin-producing cells placed inside microcapsules is being trialled to overcome the need for immunosuppressive therapy.


METHODS
Four type 1 diabetic patients with no detectable C-peptide received an intraperitoneal infusion of islets inside microcapsules of barium alginate (mean 178,200 islet equivalents on each of eight occasions).


RESULTS
C-peptide was detected on day 1 post-transplantation, and blood glucose levels and insulin requirements decreased. C-peptide was undetectable by 1-4 weeks. In a multi-islet recipient, C-peptide was detected at 6 weeks after the third infusion and remains detectable at 2.5 years. Neither insulin requirements nor glycemic control was affected. Capsules recovered at 16 months were surrounded by fibrous tissue and contained necrotic islets. No major side effects or infection occurred.


CONCLUSIONS
While allografting of encapsulated human islets is safe, efficacy of the cells needs to improve for the therapy to make an impact on the clinical scene.
Tuch
Bernard E
BE
Australian Foundation for Diabetes Research, Sydney, Australia. btuch@alumni.sydney.edu.au
Keogh
Gregory W
GW
Williams
Lindy J
LJ
Wu
Wei
W
Foster
Jayne L
JL
Vaithilingam
Vijayganapathy
V
Philips
Robert
R
D000328:Adult; D000464:Alginates / Q000737:chemistry; D001786:Blood Glucose; D002096:C-Peptide / Q000378:metabolism; D002214:Capsules / Q000008:administration & dosage* / Q000737:chemistry; D002470:Cell Survival; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005260:Female; D020723:Glucuronic Acid / Q000737:chemistry; D006603:Hexuronic Acids / Q000737:chemistry; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged
D000464:Alginates; D001786:Blood Glucose; D002096:C-Peptide; D002214:Capsules; D006603:Hexuronic Acids; D020723:Glucuronic Acid