Document Detail


Insulin independence following isolated islet transplantation and single islet infusions.
MedLine Citation:
PMID:  12796569     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To restore islet function in patients whose labile diabetes subjected them to frequent dangerous episodes of hypoglycemic unawareness, and to determine whether multiple transplants are always required to achieve insulin independence.
SUMMARY BACKGROUND DATA: The recent report by the Edmonton group documenting restoration of insulin independence by islet transplantation in seven consecutive patients with type 1 diabetes differed from previous worldwide experience of only sporadic success. In the Edmonton patients, the transplanted islet mass critical for success was approximately more than 9,000 IEq/kg of recipient body weight and required two or three separate transplants of islets isolated from two to four cadaveric donors. Whether the success of the Edmonton group can be recapitulated by others, and whether repeated transplants using multiple donors will be a universal requirement for success have not been reported.
METHODS: The authors report their treatment with islet transplantation of nine patients whose labile type 1 diabetes was characterized by frequent episodes of dangerous hypoglycemia.
RESULTS: In each of the seven patients who have completed the treatment protocol (i.e., one or if necessary a second islet transplant), insulin independence has been achieved. In five of the seven patients only a single infusion of islets was required. To date, only one recipient has subsequently lost graft function, after an initially successful transplant. This patient suffered recurrent hyperglycemia 9 months after the transplant.
CONCLUSIONS: This report confirms the efficacy of the Edmonton immunosuppressive regimen and indicates that insulin independence can often be achieved by a single transplant of sufficient islet mass.
Authors:
James F Markmann; Shaoping Deng; Xiaolun Huang; Niraj M Desai; Ergun H Velidedeoglu; Chengyang Lui; Adam Frank; Eileen Markmann; Maral Palanjian; Kenneth Brayman; Bryan Wolf; Ewan Bell; Marko Vitamaniuk; Nicolai Doliba; Franz Matschinsky; Clyde F Barker; Ali Naji
Related Documents :
11095109 - Isolated human islets trigger an instant blood mediated inflammatory reaction: implicat...
11544439 - Microcirculation of human pancreatic islets transplanted under the renal capsule of nud...
14724669 - Genetically engineered sertoli cells are able to survive allogeneic transplantation.
15627289 - Fty720: mechanism of action and potential benefit in organ transplantation.
1434789 - Mesenteric lymph node transplantation in syngeneic rats: changes in cellularity and arc...
7683109 - Carcinogenicity of azathioprine: an s-ar investigation.
24919739 - Pursuing expanded criteria donors as candidates for kidney donation after circulatory d...
10644109 - Embolization with radiopaque microbeads of polyacrylonitrile hydrogel: evaluation in sw...
1724739 - Angiogenesis after hepatic arterial occlusion in liver transplant patients.
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of surgery     Volume:  237     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-10     Completed Date:  2003-07-14     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  741-9; discussion 749-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Pennsylvania Health System, Hospital of the University of Pennsylvania, 4th Floor Silverstein, 3400 Spruce Street, Philadelphia, PA 19104, USA. james.markmann@uphs.upenn.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / analysis
C-Peptide / blood
Diabetes Mellitus, Type 1 / blood,  surgery*
Humans
Immunosuppressive Agents / therapeutic use
Islets of Langerhans Transplantation* / immunology,  methods
Recovery of Function*
Grant Support
ID/Acronym/Agency:
1U42 RR 16600/RR/NCRR NIH HHS; M01 RR 00040/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/C-Peptide; 0/Immunosuppressive Agents
Comments/Corrections
Comment In:
Curr Surg. 2005 May-Jun;62(3):305-10   [PMID:  15890213 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Central poorly differentiated adenocarcinoma of the maxilla: report of a case.
Next Document:  Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss.