title: Combined pancreatic islet and kidney transplantation in a child with unstable type 1 diabetes and end-stage renal disease.
abstract: Islet transplantation after successful kidney transplantation is a recognized treatment for adults with diabetes and end-stage renal disease (ESRD), but has not been considered an option in the pediatric population. To our knowledge, we report the first combined islet and kidney transplant in a child. The patient was born with bilateral renal hypoplasia and was diagnosed with type 1 diabetes mellitus at age 13 months. He had erratic glycemic control and hypoglycemia unawareness. At 6 years of age, the child safely underwent simultaneous islet and live donor kidney transplantation. Although function of the islet graft was transient, the combined transplant provided significant benefits in terms of glucose control and overall growth and development. Such an approach represents a viable treatment option for pediatric patients with ESRD and unstable diabetes.
authors.affiliation: Division of Nephrology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Benedict
authors.forename: S
authors.initials: S
authors.lastname: Moassesfar
authors.forename: S
authors.initials: S
authors.lastname: Adi
authors.forename: S E
authors.initials: SE
authors.lastname: Gitelman
authors.forename: J L
authors.initials: JL
authors.lastname: Brennan
authors.forename: M
authors.initials: M
authors.lastname: McEnhill
authors.forename: P G
authors.initials: PG
authors.lastname: Stock
authors.forename: A A
authors.initials: AA
authors.lastname: Portale
authors.forename: A M
authors.initials: AM
authors.lastname: Posselt
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D016035:Pancreas Transplantation; D011379:Prognosis
chemical_list: D001786:Blood Glucose
keywords: Islet transplantation; kidney transplantation; pediatric; renal disease; type I diabetes