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The Edmonton protocol is:

a. An automated method for human islet isolation
b. A minimally invasive intrahepatic islet implantation method
c. A steroid-containing immunosuppressive therapeutic regimen
d. A surgical procedure for pancreas transplantation

The Edmonton Protocol for Islet Implantation

Arguably, the most exciting recent breakthrough in islet transplantation research has been the development of a unique set of strategies for islet cell replacement. The Edmonton Protocol (named for the islet transplantation group at the University of Alberta, Edmonton, Canada) consists of the following components:

· Use of the Ricordi automated method to obtain highly purified, endotoxin-free islets.
· Minimal ischemia time and use of freshly isolated islets.
· Use of a large islet mass (~10,000 islet equivalents/kg), with most patients receiving at least 2 islet transplants.
· Use of a potent steroid-free immunosuppression protocol consisting of sirolimus, tacrolimus, and an anti-IL-2 receptor monoclonal antibody (daclizumab). Tacrolimus and sirolimus act synergistically in vivo and dramatically reduce acute rejection rates.

The actual implant is performed through a simple procedure using percutaneous transhepatic access to deliver the islet cells into a portal vein via a catheter under angiographic monitoring. Most patients are discharged within 24 hours of the procedure.

The Edmonton protocol is a minimally invasive procedure for intrahepatic islet implantation that has resulted in highly successful clinical outcomes of insulin independence in labile glycemic type 1 diabetes patients.

62nd Scientific Sessions of the American Diabetes Association
Insulin Replacement/Insulin Technologies

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