Combined pancreatic islet-lung transplantation: a novel approach to the treatment of end-stage cystic fibrosis

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Laurence KesslerGRAGIL Group

Abstract

Patients with end-stage cystic fibrosis (CF) and severe CF-related diabetes (CFRD) may benefit from combined lung-pancreatic islet transplantation. In the present study, we report the long-term follow-up of four end-stage CF patients treated with combined bilateral lung and pancreatic islet transplantation from the same donor. All patients were C-peptide negative (<0.5 microg/L) and inadequately controlled despite intensive insulin treatment. One patient was transplanted with 4 019 +/- 490 islet equivalent/kg injected into the transverse colic vein using a surgical approach. In the remaining three patients, islets were cultured for 3-6 days and transplanted by percutaneous transhepatic catheterization of the portal vein. In all patients, islet allograft recovery was recognized by elevation in the plasma level of C-peptide (>0.5 microg/L). At 6 months after transplantation, one patient showed multiple episodes of acute lung transplant rejection and a progressive decline in pancreatic islet cell function. Three out of four patients experienced an improved control of glucose levels with a HbA1c of 5.2%, 7% and 6% respectively at 1.5, 2 and 15 years follow-up. Compared with the pretransplant period, there was a 50% reduction in mea...Continue Reading

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Citations

Sep 12, 2013·Case Reports in Endocrinology·Ioulia IosfinaBradley S Quon
Feb 4, 2012·Acta Diabetologica·Han-Hung HuangLisa Stehno-Bittel
Jun 26, 2014·Diabetes Care·H Siebe SpijkerEelco J P de Koning
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May 26, 2021·Clinical Transplantation·Jonathan A FridellJohn A Powelson
Jun 2, 2021·The Journal of Clinical Endocrinology and Metabolism·Cyril P LandstraMichael R Rickels

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