Transplanted human pancreatic islets after long-term insulin independence

Article Article scientifique Rapport de cas Transplanted human pancreatic islets after long-term insulin independence eng 2013 author Muller Y D author Gupta Sajal 528305 author Morel Philippe 22337 author Borot Sophie 728912 author Bettens F author Truchetet Marie-Elise 712449 author Villard Jean 29595 author Seebach Jorg Dieter 647894 author Holmberg D author Toso Christian 0000-0003-1652-4522 92271 author Lobrinus Johannes Alexander 647649 author Bosco Domenico 23285 author Berney Thierry 63319 1093-1097 10.1111/ajt.12138 23398948 1600-6135 Long-term insulin independence after islets of Langerhans transplantation is rarely achieved. The aims of this study were to identify the histological and immunological features of islets transplanted in a type 1 diabetic patient who died of a cerebral hemorrhage after >13 years insulin independence. Islets were pooled from two donors with respectively one and five HLA mismatches. Insulin-positive islets were found throughout the right and left liver, and absent in the pancreas. Two- and three-dimensional analysis showed that islets lost their initial rounded and compact morphology, had a mean diameter of 136 μm and were constituted of an unfolded epithelial band of 39.1 μm. Leukocyte phenotyping showed no evidence of a tolerogenic environment in the islet-containing portal spaces. Finally, HLA typing of microdissected islets showed HLA from the best matched donor in all 23 microdissection samples, compared to 1/23 for the least matched donor. This case report demonstrates that allogeneic islets can survive over 13 years while maintaining insulin independence. Allogeneic islets had unique morphologic features and implanted in the liver regardless of their size. Finally, our results suggest that, in this case, rejection had been prevalent over autoimmunity, although this hypothesis warrants further investigation. Dewey 616 Dewey 616.07 Dewey 617 137 Département de pathologie et immunologie 21F 56 Département de médecine 221 57 Département de chirurgie 222 false 79 Chirurgie viscérale 104 1329 Chirurgie viscérale (HUG) 357 La transplantation d'îlots de Langerhans 623 518 Cellules NK et récepteurs FcyR dans l'auto-immunité et le rejet de xénotransplantation 856 391 Métastases du foie 657 298 Immunologie de transplantation, immunogénétique et thérapie cellulaire 561 562 Transplantation et hépatologie 905 American journal of transplantation 13 4 4b39be7e-8123-4af4-ab7f-9152d9e0725c Article (Published version) Restricted Lobrinus JA Am J Transplant 2013, 13(4),1093.pdf 707830 application/pdf restrictedAccess Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Transplanted human pancreatic islets after long-term insulin independence	American journal of transplantation			2013	873	1

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Gupta, Sajal