Human islet isolation and allotransplantation in 22 consecutive cases

Camillo Ricordi, Andreas G. Tzakis, Patricia B. Carroll, Yijun Zeng, Horacio L. Rodriguez Rilo, Rodolfo Alejandro, Ron Shapiro, John J. Fung, Anthony J. Demetris, Daniel H. Mintz, Thomas E. Starzl

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191 Scopus citations

Abstract

This report provides our initial experience in islet isolation and intrahepatic allotransplantation in 21 patients. In group 1, 10 patients underwent combined liver-islet allotransplantation following upper-abdominal exenteration for cancer. In group 2, 4 patients received a combined liver- islet allograft for cirrhosis and diabetes. One patient had plasma C-peptide >3 pM and was therefore excluded from analysis. In group 3, 7 patients received 8 combined cadaveric kidney-islet grafts (one retransplant) for end- stage renal disease secondary to type 1 diabetes mellitus. The islets were separated by a modification of the automated method for human islet isolation and the preparations were infused into the portal vein. Immunosuppression was with FK506 (group 1) plus steroids (groups 2 and 3). Six patients in group 1 did not require insulin treatment for 5 to >16 months. In groups 2 and 3 none of the patients became insulin-independent, although decreased insulin requirement and stabilization of diabetes were observed. Our results indicate that rejection is still a major factor limiting the clinical application of islet transplantation in patients with type 1 diabetes mellitus, although other factors such as steroid treatment may contribute to deteriorate islet engraftment and/or function.

Original languageEnglish (US)
Pages (from-to)407-414
Number of pages8
JournalTransplantation
Volume53
Issue number2
DOIs
StatePublished - Feb 1992

ASJC Scopus subject areas

  • Transplantation

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    Ricordi, C., Tzakis, A. G., Carroll, P. B., Zeng, Y., Rodriguez Rilo, H. L., Alejandro, R., Shapiro, R., Fung, J. J., Demetris, A. J., Mintz, D. H., & Starzl, T. E. (1992). Human islet isolation and allotransplantation in 22 consecutive cases. Transplantation, 53(2), 407-414. https://doi.org/10.1097/00007890-199202010-00027