Transplantation for type I diabetes: comparison of vascularized whole-organ pancreas with isolated pancreatic islets

Annals of Surgery
Adam FrankJames F Markmann

Abstract

We sought to compare the efficacy, risks, and costs of whole-organ pancreas transplantation (WOP) with the costs of isolated islet transplantation (IIT) in the treatment of patients with type I diabetes mellitus. A striking improvement has taken place in the results of IIT with regard to attaining normoglycemia and insulin independence of type I diabetic recipients. Theoretically, this minimally invasive therapy should replace WOP because its risks and expense should be less. To date, however, no systematic comparisons of these 2 options have been reported. We conducted a retrospective analysis of a consecutive series of WOP and IIT performed at the University of Pennsylvania between September 2001 and February 2004. We compared a variety of parameters, including patient and graft survival, degree and duration of glucose homeostasis, procedural and immunosuppressive complications, and resources utilization. Both WOP and IIT proved highly successful at establishing insulin independence in type I diabetic patients. Whole-organ pancreas recipients experienced longer lengths of stay, more readmissions, and more complications, but they exhibited a more durable state of normoglycemia with greater insulin reserves. Achieving insulin i...Continue Reading

References

Jan 1, 1989·Diabetes·C RicordiD W Scharp
Jan 28, 1988·The New England Journal of Medicine·R C RamsayJ S Najarian
Jul 9, 1998·The New England Journal of Medicine·P FiorettoM Mauer
Feb 16, 2000·Annals of Surgery·A HumarD E Sutherland
Aug 31, 2002·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Dixon B KaufmanFrank P Stuart
Jun 7, 2003·Transplantation·James F MarkmannAli Naji
Oct 22, 2003·Lancet·A M James ShapiroBernhard Hering
Dec 6, 2003·JAMA : the Journal of the American Medical Association·Jeffrey M VenstromDavid M Harlan
Feb 14, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Bernhard J HeringJeffrey A Bluestone

❮ Previous
Next ❯

Citations

Oct 2, 2007·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Nicholas OnacaMarlon F Levy
Sep 20, 2019·Lancet·Marie-Christine VantyghemMichael R Rickels
Aug 7, 2012·Cell Transplantation·Efstathios S AvgoustiniatosKlearchos K Papas
Sep 1, 2008·Journal of Diabetes Science and Technology·John T Wilson, Elliot L Chaikof
May 17, 2021·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Aleksandra KuklaMichael R Rickels
Mar 2, 2005·Journal of the American College of Surgeons·James A Schulak
Dec 24, 2005·Expert Opinion on Biological Therapy·Shinichi MatsumotoCamillo Ricordi
Oct 11, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A N BalamuruganRita Bottino
May 25, 2005·Transplantation·A M James ShapiroEdmond A Ryan
Jul 5, 2005·Annales de chirurgie·P BucherP Morel
Oct 28, 2005·Advances in Surgery·Adam M FrankJames F Markmann
Jun 1, 2005·Archives of Medical Research·Jason L GagliaGordon C Weir
Apr 14, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·C TosoUNKNOWN GRAGIL group
Nov 30, 2006·Annals of the New York Academy of Sciences·Antonello PileggiCamillo Ricordi
May 10, 2007·The Journal of Clinical Endocrinology and Metabolism·Michael R RickelsAli Naji
Aug 24, 2007·Transplantation·Benjamin E Hippen
Oct 27, 2007·Expert Opinion on Biological Therapy·Simona MarzoratiCamillo Ricordi
Feb 4, 2006·Cell Transplantation·Yukihide YonekawaKoichi Tanaka
Jun 19, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J F MarkmannP G Stock
Oct 16, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Davide MineoCamillo Ricordi
Oct 30, 2008·The Journal of Clinical Endocrinology and Metabolism·Michael R RickelsAli Naji
Dec 10, 2008·Expert Opinion on Biological Therapy·C G Thanos, R B Elliott
Jun 10, 2009·Tissue Engineering. Part C, Methods·Rustin M ShenkmanKlearchos K Papas
Apr 13, 2010·Expert Review of Clinical Immunology·Jamil AzziReza Abdi
Jan 28, 2010·Acta Biomaterialia·John T WilsonElliot L Chaikof
Mar 18, 2010·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Klearchos K PapasMaria Koulmanda
Apr 24, 2010·Diabetes·Martha M SklavosJon D Piganelli
Nov 26, 2010·Islets·Tatsuya Kin, A M James Shapiro

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.