Pancreatic islet transplantation after upper abdominal exenteration and liver replacement

Andreas G. Tzakis, Camillo Ricordi, Rodolfo Alejandro, Yijun Zeng, John J. Fung, Satoru Todo, Anthony J. Demetris, Rodolfo Alejandro, Camillo Ricordi

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Abstract

Nine patients who became diabetic after upper-abdominal exenteration and liver transplantation were given pancreatic islet-cell grafts obtained from the liver donor (eight cases), a third-party donor (one), or both (four). Two patients were diabetic when they died of infections after 48 and 109 days, as was a third patient who died of tumour recurrence after 178 days. The other 6 are alive 101-186 days postoperatively, and five are insulin-free or on insulin only during night-time parenteral alimentation. C-peptide increased 1.7 to 3.3 fold in response to intravenous glucose in these five patients who have had glycosylated haemoglobin in the high normal range. However, the kinetics of the C-peptide responses to intravenous glucose in all eight patients tested revealed an absent first-phase release and a delayed peak response consistent with transplantation and/or engraftment of a suboptimal islet cell mass. The longest survivor, who requires neither parenteral alimentation nor insulin, is the first unequivocal example of successful clinical islet-cell transplantation.

Original languageEnglish
Pages (from-to)402-405
Number of pages4
JournalLancet
Volume336
Issue number8712
StatePublished - Dec 1 1990

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Islets of Langerhans Transplantation
Islets of Langerhans
Liver
C-Peptide
Insulin
Tissue Donors
Glucose
Cell Transplantation
Glycosylated Hemoglobin A
Liver Transplantation
Survivors
Reference Values
Transplantation
Transplants
Recurrence
Infection
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tzakis, A. G., Ricordi, C., Alejandro, R., Zeng, Y., Fung, J. J., Todo, S., ... Ricordi, C. (1990). Pancreatic islet transplantation after upper abdominal exenteration and liver replacement. Lancet, 336(8712), 402-405.

Pancreatic islet transplantation after upper abdominal exenteration and liver replacement. / Tzakis, Andreas G.; Ricordi, Camillo; Alejandro, Rodolfo; Zeng, Yijun; Fung, John J.; Todo, Satoru; Demetris, Anthony J.; Alejandro, Rodolfo; Ricordi, Camillo.

In: Lancet, Vol. 336, No. 8712, 01.12.1990, p. 402-405.

Research output: Contribution to journalArticle

Tzakis, AG, Ricordi, C, Alejandro, R, Zeng, Y, Fung, JJ, Todo, S, Demetris, AJ, Alejandro, R & Ricordi, C 1990, 'Pancreatic islet transplantation after upper abdominal exenteration and liver replacement', Lancet, vol. 336, no. 8712, pp. 402-405.
Tzakis AG, Ricordi C, Alejandro R, Zeng Y, Fung JJ, Todo S et al. Pancreatic islet transplantation after upper abdominal exenteration and liver replacement. Lancet. 1990 Dec 1;336(8712):402-405.
Tzakis, Andreas G. ; Ricordi, Camillo ; Alejandro, Rodolfo ; Zeng, Yijun ; Fung, John J. ; Todo, Satoru ; Demetris, Anthony J. ; Alejandro, Rodolfo ; Ricordi, Camillo. / Pancreatic islet transplantation after upper abdominal exenteration and liver replacement. In: Lancet. 1990 ; Vol. 336, No. 8712. pp. 402-405.
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