Issue 138 Item 14 Pancreatic Islet Transplantation Produced Insulin Independence

Early data demonstrate that pancreatic islet transplantation produces insulin independence in patients with type-1 diabetes. Researchers from Baylor College of Medicine, Houston, Texas, United States, performed pancreatic islet transplantation in three patients with type 1 diabetes. They also had histories of severe hypoglycaemia and metabolic instability. Islet isolation, at a site distant from the transplantation centre, began within 6.5 hours.

All three patients attained sustained insulin independence after transplantation of between 395,567 and 563,206 pancreatic islet equivalents (IEQ). Two patients underwent a second islet transplant with 326,720 and 768,132 IEQ to increase functional pancreatic islet reserve. Follow-up was between 0.5 and 4 months.

Mean glycosylated haemoglobin values and the mean amplitude of glycaemic excursions declined in two and three patients respectively. Islet allografts responded to in vitro glucose stimulus before and after shipment to the transplant centre. No patient experienced hyperglycaemic or hypoglycaemic episodes since the transplant. No complications occurred.

The authors came to three conclusions: first, pancreatic islets remain viable after shipment to remote sites for transplantation; second, a small number of regional units could supply isolated pancreatic islets to remote transplant centres and third, that pancreatic islet transplantation performed by remote centres can produce insulin independence.
Transplantation 2002;27:1761-6