title: Outcome of human islet isolation and allotransplantation in 20 consecutive cases.
abstract: This report provides our initial experience on islet isolation and intrahepatic allotransplantation in 20 patients. In Group 1, 10 patients underwent combined liver-islet allotransplantation following upper-abdominal exenteration for cancer. One patient underwent pancreatic islet allograft after near total pancreatectomy for chronic pancreatitis. In Group 2, 3 Type I diabetic patients received a combined liver-islet allograft for cirrhosis and diabetes. In Group 3, 7 Type I diabetic patients received 8 combined cadaveric kidney-islet grafts (one retransplant) for end stage renal disease. The islets were separated by a modification of the automated method for human islet isolation and the preparations were infused into the portal vein. Immunosuppression was with FK-506 (Group 1) plus steroids (Groups 2 and 3). Six patients in Group 1 did not require insulin treatment for 5 to >16 mo. In Groups 2 and 3 none of the patients became insulin-independent, although ongoing C-peptide secretion, decreased insulin requirement and stabilization of diabetes were observed. Our results indicate that islet transplantation is most effective in pancreatectomy induced diabetes. However, rejection is still a major factor limiting the clinical application of islet transplantation in patients with Type I diabetes mellitus. Other factors such as steroid treatment may contribute to deteriorate islet engraftment and/or function.
authors.affiliation: Transplant Institute, University of Pittsburgh Schoo1 of Medicine, Pittsburgh, Pennsylvania.
authors.forename: C
authors.initials: C
authors.lastname: Ricordi
authors.forename: P
authors.initials: P
authors.lastname: Carroll
authors.forename: A
authors.initials: A
authors.lastname: Tzakis
authors.forename: Y
authors.initials: Y
authors.lastname: Zeng
authors.forename: H L R
authors.initials: HL
authors.lastname: Rilo
authors.forename: R
authors.initials: R
authors.lastname: Alejandro
authors.forename: R
authors.initials: R
authors.lastname: Shapiro
authors.forename: J J
authors.initials: JJ
authors.lastname: Fung
authors.forename: A J
authors.initials: AJ
authors.lastname: Demetris
authors.forename: D H
authors.initials: DH
authors.lastname: Mintz
authors.forename: T E
authors.initials: TE
authors.lastname: Starzl