title: Long-term metabolic and immunological follow-up of nonimmunosuppressed patients with type 1 diabetes treated with microencapsulated islet allografts: four cases.
abstract: OBJECTIVE
  To assess long-term metabolic and immunological follow-up of microencapsulated human islet allografts in nonimmunosuppressed patients with type 1 diabetes (T1DM).
  
  
  METHODS
  Four nonimmunosuppressed patients, with long-standing T1DM, received intraperitoneal transplant (TX) of microencapsulated human islets. Anti-major histocompatibility complex (MHC) class I-II, GAD65, and islet cell antibodies were measured before and long term after TX.
  
  
  RESULTS
  All patients turned positive for serum C-peptide response, both in basal and after stimulation, throughout 3 years of posttransplant follow-up. Daily mean blood glucose, as well as HbA(1c) levels, significantly improved after TX, with daily exogenous insulin consumption declining in all cases and being discontinued, just transiently, only in patient 4. Anti-MHC class I-II and GAD65 antibodies all tested negative at 3 years after TX.
  
  
  CONCLUSIONS
  The grafts did not elicit any immune response, even in the cases where more than one preparation was transplanted, as a unique finding, compatible with encapsulation-driven "bioinvisibility" of the grafted islets. This result had never been achieved with the recipient's general immunosuppression.
authors.affiliation: Department of Internal Medicine, Laboratory for the Study and Transplant of Pancreatic Islets, University of Perugia, Perugia, Italy. islet@unipg.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Basta
authors.forename: Pia
authors.initials: P
authors.lastname: Montanucci
authors.forename: Giovanni
authors.initials: G
authors.lastname: Luca
authors.forename: Carlo
authors.initials: C
authors.lastname: Boselli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Noya
authors.forename: Barbara
authors.initials: B
authors.lastname: Barbaro
authors.forename: Meirigeng
authors.initials: M
authors.lastname: Qi
authors.forename: Katie P
authors.initials: KP
authors.lastname: Kinzer
authors.forename: José
authors.initials: J
authors.lastname: Oberholzer
authors.forename: Riccardo
authors.initials: R
authors.lastname: Calafiore
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000276:immunology / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D005500:Follow-Up Studies; D005968:Glutamate Decarboxylase / Q000276:immunology / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007165:Immunosuppression Therapy; D007515:Islets of Langerhans / Q000166:cytology* / Q000276:immunology; D016381:Islets of Langerhans Transplantation / Q000276:immunology* / Q000379:methods*; D008285:Major Histocompatibility Complex / Q000276:immunology; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D001786:Blood Glucose; D002096:C-Peptide; D005968:Glutamate Decarboxylase; D006442:Glycated Hemoglobin; C024211:islet cell antibody; C401141:glutamate decarboxylase 2