Clinical islet transplantation in type 1 diabetes mellitus: results of Australia's first trial.

The Medical Journal of Australia
Philip J O'ConnellJeremy R Chapman

Abstract

To determine whether pancreatic islet transplantation can control diabetes and prevent severe life-threatening hypoglycaemia. A single-arm observation study of six patients undergoing islet transplantation. All patients had had type 1 diabetes mellitus for over 5 years and documented episodes of repeated severe hypoglycaemia. Islets were isolated from donor pancreases digested by Liberase. Separated islets were infused into the recipient's liver via the portal vein. Patients were immunosuppressed with daclizumab, sirolimus and tacrolimus. The transplants were performed at Westmead Hospital, NSW, between October 2002 and February 2005. Normal blood glucose control without administration of exogenous insulin; demonstration of islet function and abolition of hypoglycaemia. Five of the patients received two islet infusions, and the sixth was withdrawn after one infusion following a portal vein thrombosis. Three patients became insulin-independent, with excellent glycaemic control. Two had islet function with circulating C-peptide, improved glycaemic control, reduced insulin requirement and abolition of severe hypoglycaemia. However, over a 2-year period, graft function deteriorated. Recipients who were initially insulin free remain...Continue Reading

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