Endogenous Insulin Production Maintained in Type 1 Diabetic Patients 3 Years After Islet Transplant: Presented at ATC

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Title: Endogenous Insulin Production Maintained in Type 1 Diabetic Patients 3 Years After Islet Transplant: Presented at ATC
URL: http://www.pslgroup.com/dg/2231EE.htm
Doctor's Guide
June 6, 2008

By Thomas S. May

TORONTO -- June 6, 2008 -- Four out of 5 patients with type 1 diabetes who completed islet transplantation procedures optimised for donation-after-cardiac-death (DCD) donors have maintained endogenous insulin production 3 years after transplantation, researchers reported here at the 2008 American Transplant Congress (ATC).

"This was achieved by the establishment of an improved islet isolation method that we call the Kyoto islet isolation method," said Teru Okitsu, MD, PhD, Kyoto University Hospital, Kyoto, Japan, in a presentation on June 1.

The focus of Dr. Okitsu's presentation was the outcomes of the 8 patients with type 1 diabetes and severe hypoglycaemia who were given intraportal infusions of allogeneic islets from DCD donors in 2004 at his institution. Patients also received an immunosuppressive regimen comprised of basiliximab induction and sirolimus, tacrolimus, and mycophenolate mofetil maintenance.

All recipients became free from hypoglycaemic episodes and were positive for C-peptide after transplantation, indicative of islet function, the researchers reported. Five of the patients completed the procedure consisting of 2 to 3 islet infusions (19,700 IEQ/kg). Four of these recipients have preserved endogenous insulin secretion for more than 3 years after the first islet infusion.

Three of the patients became insulin independent and their haemoglobin A1C levels remained normal, requiring only small amounts of insulin at 14, 79, and 215 days after the last islet infusion.

"This work clearly shows that marginal donors such as DCDs are eligible for islet transplantation," said Dr. Okitsu.

He noted that the study dealt with an issue that researchers in North America and Europe are likely to face in the near future, as islet transplantation becomes more widespread.

In the West, islet transplantation is performed only in the context of clinical research, and there is no donor shortage, Dr. Okitsu noted. But this situation is likely to change once the procedure becomes established as an accepted form of therapy for insulin-dependent diabetes, he argued.

"In Japan, because of specific social circumstances, only DCDs are available for islet transplantation," Dr. Okitsu explained. "This condition forced us to face this issue in advance of the Western countries, and we were able to prepare a possible solution for it," he said.

[Presentation title: Three Year Follow-Up After Clinical Islet Transplantation From Donation-After-Cardiac-Death (DCD) Donors to Type 1 Diabetic Patients. Abstract 956]

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