Allograft islets transplantation for type 1 diabetes mellitus and 3-year follow-up: 10 cases reportr

Abstract

Objective To evaluate the 3-year follow-up outcomes of allograft islet transplantation for type 1 diabetes mellitus (T1DM). Method Ten cases of T1DM were subjected to islet transplantations. The pancreases were digested by Liberase collagenase enzyme and islets with high activity were purified using continuous gradients of Ficoll-diatrizoic acid on a refrigerated COBE 2991 centrifuge. Cultured islets were infused by minimally invasive surgical approach to the liver via portal vasculature. After islet cell transplantation, a modified Edmonton immunosuppresion protocol containing antithymocyte globulin (ATG) and Etanercept, tacrolimus and mycophenolate mofetil was used, and the changes in blood glucose, C peptide and glycate hemoglobin were monitored regularly during a follow-up period of 3 years. Result The glucocorticoid-free immunosuppressive regimen was used. During the follow-up period of 36 months, 6 recipients remained insulin-independent. The dosage of insulin decreased by 60% in 4 patients. The levels of blood glucose and HbA1c were all within normal range and liver and renal functions were normal. C-peptide level was normal. No complications related to islet infusion were observed. Conclusion Medium-term clinical effect of islet transplantation is effective and safe for treating T1DM. Key words: Pancreatic islet transplantation; Diabetes Mellitus; Immunosuppression