Pancreatic islet transplantation after upper abdominal exeriteration and liver replacement

A. G. Tzakis, Y. Zeng, J. J. Fung, S. Todo, A. J. Demetris, T. E. Starzl, D. H. Mintz, R. Alejandro, C. 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 (US)
Pages (from-to)402-405
Number of pages4
JournalThe Lancet
Volume336
Issue number8712
DOIs
StatePublished - Aug 18 1990

ASJC Scopus subject areas

  • Medicine(all)

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    Tzakis, A. G., Zeng, Y., Fung, J. J., Todo, S., Demetris, A. J., Starzl, T. E., Mintz, D. H., Alejandro, R., & Ricordi, C. (1990). Pancreatic islet transplantation after upper abdominal exeriteration and liver replacement. The Lancet, 336(8712), 402-405. https://doi.org/10.1016/0140-6736(90)91946-8