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Islet of Langerhans transplantation for the treatment of type 1 diabetes.
- Source :
-
Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera [Swiss Surg] 2003; Vol. 9 (5), pp. 242-6. - Publication Year :
- 2003
-
Abstract
- Islet of Langerhans transplantation is gaining recognition as a therapy for type 1 diabetes. The procedure involves enzymatic digestion of the pancreatic tissue, purification of the islets from the exocrine tissue, infusion of the islets into the portal vein and implantation in the liver. Until 1999, and overall rate of insulin independence of 14% at one year was reported in the International Islet Transplant Registry. The results of the "Edmonton protocol" since 2000 were a breakthrough in the field, with reports of 80% insulin independence at 1-year after solitary islet transplantation in non uremic patients with brittle type 1 diabetes. A rapamycin-based, steroid-free, islet-sparing immunosuppressive regimen was designed and the problem of the insufficient islet mass was tackled by sequential infusions of islets isolated from at least two pancreatic. The University of Geneva has been involved in clinical islet transplantation since 1992, and has performed 51 allogeneic and 17 autologous. Twenty-one patients have been transplanted in Geneva since 2002. They were five solitary islet transplants, 14 islet after kidney transplants and two simultaneous islet-kidney (SIK) recipients. Insulin independence was achieved in 67%.
- Subjects :
- Diabetes Mellitus, Type 1 mortality
Drug Therapy, Combination
Follow-Up Studies
Humans
Immunosuppressive Agents adverse effects
Immunosuppressive Agents therapeutic use
Insulin metabolism
Insulin Secretion
Kidney Transplantation methods
Sirolimus adverse effects
Sirolimus therapeutic use
Switzerland
Tissue and Organ Harvesting methods
Transplantation, Heterotopic methods
Diabetes Mellitus, Type 1 surgery
Islets of Langerhans Transplantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 1023-9332
- Volume :
- 9
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera
- Publication Type :
- Academic Journal
- Accession number :
- 14601328
- Full Text :
- https://doi.org/10.1024/1023-9332.9.5.242