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Title

Long-term insulin-independence after allogeneic islet transplantation for type 1 diabetes: over the 10-year mark

Authors
Marangon, N.
Published in American Journal of Transplantation. 2009, vol. 9, no. 2, p. 419-23
Abstract Results of islet of Langerhans transplantation have markedly improved in recent years, but most patients still lose insulin independence in the long-term. We report herein the longest (over 11 years) case of insulin independence after allogeneic islet transplantation. The subject had a 27-year history of type 1 diabetes and received a single islet-after-kidney graft of 8800 islet equivalents (IEQ)/kg, pooled from 2 donors. Insulin was discontinued by 3 months posttransplant and the patient has remained off insulin ever since. Yearly follow-up studies have revealed normal metabolic control, including normal oral glucose tolerance test (OGTT). Reasons for success may involve choice of immunosuppression, low metabolic demand and low immune responsiveness as suggested by an excellent HLA matching and a high count of circulating regulatory T cells. This observation is so far an exceptional case, but clearly demonstrates the validity of the concept that long-term insulin independence after allogeneic islet transplantation is an achievable target.
Keywords AdultBlood Glucose/metabolismDiabetes Mellitus, Type 1/surgeryFemaleGraft SurvivalHumansHypoglycemic Agents/bloodImmunosuppressionInsulin/bloodIslets of Langerhans TransplantationPostoperative PeriodTime FactorsTransplantation, HomologousTreatment Outcome
Stable URL https://archive-ouverte.unige.ch/unige:1288
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Identifiers
PMID: 19120085
Structures
Research groups Chirurgie viscérale (104)
Diabète et régulation des gènes (36)
Cultures cellulaires et transplantations (519)
Transplantation Immunologie et Osteoimmunologie (561)
La transplantation d'îlots de Langerhans (623)

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Deposited on : 2009-04-01

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