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Transplanted human pancreatic islets after long-term insulin independence

Publié dansAmerican journal of transplantation, vol. 13, no. 4, p. 1093-1097
Date de publication2013
Résumé

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.

Citation (format ISO)
MULLER, Y D et al. Transplanted human pancreatic islets after long-term insulin independence. In: American journal of transplantation, 2013, vol. 13, n° 4, p. 1093–1097. doi: 10.1111/ajt.12138
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ISSN du journal1600-6135
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Création29.05.2013 14:03:00
Première validation29.05.2013 14:03:00
Heure de mise à jour14.03.2023 20:19:12
Changement de statut14.03.2023 20:19:12
Dernière indexation16.01.2024 01:51:13
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