title: Co-infusion of adipose tissue derived mesenchymal stem cell-differentiated insulin-making cells and haematopoietic cells with renal transplantation: a novel therapy for type 1 diabetes mellitus with end-stage renal disease.
abstract: Type 1 diabetes mellitus (T1DM) is a common cause of end-stage renal disease (ESRD). Various factors contribute to wide fluctuations in blood glucose levels and exogenous insulin requirement in such patients even after renal transplantation (RT). Simultaneous pancreas-kidney transplantation is one of the therapies for these patients. Stem cell (SC) therapy for T1DM and for minimisation of immunosuppression after RT has shown encouraging results. We report a 30-year-old-man with T1DM since 15 years and ESRD since 2 years, who underwent living donor RT and co-infusion of in vitro generated insulin-making cells differentiated from donor adipose tissue derived mesenchymal stem cells and bone marrow -derived haematopoietic SC into subcutaneous tissue, portal and thymic circulation under non-myeloablative conditioning. Over follow-up of 13 months he has stable graft function with serum creatinine, 1.2 mg/dl, zero rejection and glycosylated haemoglobin level of 6.1% on calcineurin-inhibitor based therapy.
authors.affiliation: Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G R Doshi and K M Mehta Institute of Kidney Diseases & Research Centre (IKDRC)-Dr H L Trivedi Institute of Transplantation Sciences (ITS), Ahmedabad, Gujarat, India.
authors.forename: Shruti D
authors.initials: SD
authors.lastname: Dave
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Vanikar
authors.forename: Hargovind L
authors.initials: HL
authors.lastname: Trivedi
mesh_terms: D000273:Adipose Tissue / Q000166:cytology; D000328:Adult; D002454:Cell Differentiation; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D050417:Insulin-Secreting Cells / Q000637:transplantation*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells / Q000166:cytology; D016896:Treatment Outcome