Related Experiment Videos
Human islet isolation and allotransplantation in 22 consecutive cases
C Ricordi1, A G Tzakis, P B Carroll
1University of Pittsburgh, Transplant Institute, Pennsylvania 15213.
Transplantation
|February 1, 1992
Summary
Islet transplantation shows promise for type 1 diabetes, with some patients achieving insulin independence after combined liver-islet transplants. However, rejection and steroid use remain significant challenges for islet engraftment and function.
Area of Science:
- Transplantation immunology
- Endocrinology
- Hepatology
Background:
- Islet transplantation is a potential treatment for type 1 diabetes mellitus.
- Intrahepatic allotransplantation offers a route for islet delivery.
- Previous studies highlight challenges in islet engraftment and function.
Purpose of the Study:
- To report initial clinical experience with islet isolation and intrahepatic allotransplantation.
- To evaluate outcomes in patients undergoing combined liver-islet or kidney-islet transplantation.
- To identify factors affecting islet graft success.
Main Methods:
- Modified automated method for human islet isolation.
- Intrahepatic islet infusion into the portal vein.
- Immunosuppression protocols involving FK506 and steroids.
Main Results:
- Six of ten patients in the combined liver-islet group for cancer achieved insulin independence.
- No patients in the cirrhosis or kidney-islet groups became insulin-independent.
- Decreased insulin requirements and diabetes stabilization were observed in some patients.
- Rejection emerged as a primary limitation, with potential contributions from steroid treatment.
Conclusions:
- Combined liver-islet allotransplantation can lead to insulin independence in select patients.
- Rejection remains a critical barrier to widespread clinical application of islet transplantation.
- Further research is needed to optimize immunosuppression and improve islet engraftment and long-term function.