title: Islet transplantation stabilizes hemostatic abnormalities and cerebral metabolism in individuals with type 1 diabetes.
abstract: OBJECTIVE Islets after kidney transplantation have been shown to positively affect the quality of life of individuals with type 1 diabetes (T1D) by reducing the burden of diabetes complications, but fewer data are available for islet transplantation alone (ITA). The aim of this study was to assess whether ITA has a positive impact on hemostatic and cerebral abnormalities in individuals with T1D. RESEARCH DESIGN AND METHODS Prothrombotic factors, platelet function/ultrastructure, and cerebral morphology, metabolism, and function have been investigated over a 15-month follow-up period using ELISA/electron microscopy and magnetic resonance imaging, nuclear magnetic resonance spectroscopy, and neuropsychological evaluation (Profile of Mood States test and paced auditory serial addition test) in 22 individuals with T1D who underwent ITA (n = 12) or remained on the waiting list (n = 10). Patients were homogeneous with regard to metabolic criteria, hemostatic parameters, and cerebral morphology/metabolism/function at the time of enrollment on the waiting list. RESULTS At the 15-month follow-up, the group undergoing ITA, but not individuals with T1D who remained on the waiting list, showed 1) improved glucose metabolism; 2) near-normal platelet activation and prothrombotic factor levels; 3) near-normal cerebral metabolism and function; and 4) a near-normal neuropsychological test. CONCLUSIONS ITA, despite immunosuppressive therapy, is associated with a near-normalization of hemostatic and cerebral abnormalities.
authors.affiliation: Corresponding author: Paolo Fiorina, paolo.fiorina@childrens.harvard.edu.
authors.forename: Francesca
authors.initials: F
authors.lastname: D'Addio
authors.forename: Paola
authors.initials: P
authors.lastname: Maffi
authors.forename: Paolo
authors.initials: P
authors.lastname: Vezzulli
authors.forename: Andrea
authors.initials: A
authors.lastname: Vergani
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mello
authors.forename: Roberto
authors.initials: R
authors.lastname: Bassi
authors.forename: Rita
authors.initials: R
authors.lastname: Nano
authors.forename: Monica
authors.initials: M
authors.lastname: Falautano
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Coppi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Finzi
authors.forename: Armando
authors.initials: A
authors.lastname: D'Angelo
authors.forename: Isabella
authors.initials: I
authors.lastname: Fermo
authors.forename: Fabio
authors.initials: F
authors.lastname: Pellegatta
authors.forename: Stefano
authors.initials: S
authors.lastname: La Rosa
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Magnani
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Piemonti
authors.forename: Andrea
authors.initials: A
authors.lastname: Falini
authors.forename: Franco
authors.initials: F
authors.lastname: Folli
authors.forename: Antonio
authors.initials: A
authors.lastname: Secchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Fiorina
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001792:Blood Platelets / Q000473:pathology / Q000502:physiology; D001921:Brain / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery*; D005260:Female; D006487:Hemostasis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation; D008297:Male; D010865:Pilot Projects; D011788:Quality of Life; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D007166:Immunosuppressive Agents
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