title: Autologous pancreatic islet transplantation in human bone marrow.
abstract: The liver is the current site of choice for pancreatic islet transplantation, even though it is far from being ideal. We recently have shown in mice that the bone marrow (BM) may be a valid alternative to the liver, and here we report a pilot study to test feasibility and safety of BM as a site for islet transplantation in humans. Four patients who developed diabetes after total pancreatectomy were candidates for the autologous transplantation of pancreatic islet. Because the patients had contraindications for intraportal infusion, islets were infused in the BM. In all recipients, islets engrafted successfully as shown by measurable posttransplantation C-peptide levels and histopathological evidence of insulin-producing cells or molecular markers of endocrine tissue in BM biopsy samples analyzed during follow-up. Thus far, we have recorded no adverse events related to the infusion procedure or the presence of islets in the BM. Islet function was sustained for the maximum follow-up of 944 days. The encouraging results of this pilot study provide new perspectives in identifying alternative sites for islet infusion in patients with type 1 diabetes. Moreover, this is the first unequivocal example of successful engraftment of endocrine tissue in the BM in humans.
authors.affiliation: Islet Transplantation Unit, Diabetes Research Institute, Ospedale San Raffaele, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Maffi
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Balzano
authors.forename: Maurilio
authors.initials: M
authors.lastname: Ponzoni
authors.forename: Rita
authors.initials: R
authors.lastname: Nano
authors.forename: Valeria
authors.initials: V
authors.lastname: Sordi
authors.forename: Raffaella
authors.initials: R
authors.lastname: Melzi
authors.forename: Alessia
authors.initials: A
authors.lastname: Mercalli
authors.forename: Marina
authors.initials: M
authors.lastname: Scavini
authors.forename: Antonio
authors.initials: A
authors.lastname: Esposito
authors.forename: Jacopo
authors.initials: J
authors.lastname: Peccatori
authors.forename: Elisa
authors.initials: E
authors.lastname: Cantarelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Messina
authors.forename: Massimo
authors.initials: M
authors.lastname: Bernardi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Maschio
authors.forename: Carlo
authors.initials: C
authors.lastname: Staudacher
authors.forename: Claudio
authors.initials: C
authors.lastname: Doglioni
authors.forename: Fabio
authors.initials: F
authors.lastname: Ciceri
authors.forename: Antonio
authors.initials: A
authors.lastname: Secchi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Piemonti
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001853:Bone Marrow / Q000378:metabolism*; D002096:C-Peptide / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016381:Islets of Langerhans Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010865:Pilot Projects; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D002096:C-Peptide