Insulin independence after islet transplantation into type I diabetic patient

David W. Scharp, Paul E. Lacy, Julio V. Santiago, Christopher S. Mccullough, Lamont G. Weide, Luca Falqui, Piero Marchetti, Ronald L. Gingerich, Allan S Jaffe, Philip E. Cryer, Charles B. Anderson, M. Wayne Flye

Research output: Contribution to journalArticle

297 Citations (Scopus)

Abstract

Effective clinical trials of islet transplantation have been limited by the inability to transplant enough viable human islets into patients with type I (insulin-dependent) diabetes mellitus to eliminate their exogenous insulin requirement. We report the first type I diabetic patient with an established kidney transplant on basal cyclosporin immunosuppression who was able to eliminate the insulin requirement after human islet transplantation into the portal vein. We successfully isolated ∼800,000 islets that were 95% pure from 1.4 cadaver pancreases containing 121 U of insulin. Islets were proven viable by in vitro insulin response to glucose challenge. After 7 days of 24°C culture, the islets were transplanted into the portal vein under local anesthesia. Seven days of Minnesota antilymphoblast globulin (20 mg/kg) administration followed the islet transplantation, with maintenance of the cyclosporin. Blood glucose was kept under strict control via intravenous insulin for 10 days posttransplantation, when all insulin therapy was stopped. Off insulin, the average 24-h blood glucose level remained <150 mg/dl, with the fasting glucose level at 115 ± 6 mg/dl and the 2-h postprandial level at 141 ± 8 mg/dl for 22 days posttransplantation (the time of this study). The C-peptide values post-Sustacal testing, although initially rising slower, exceeded the normal range, with peak values of 1.0-1.8 pmol/ml. This preliminary result represents the first essential step required to determine the feasibility of islet transplantation by future clinical trials.

Original languageEnglish (US)
Pages (from-to)515-518
Number of pages4
JournalDiabetes
Volume39
Issue number4
StatePublished - Apr 1990
Externally publishedYes

Fingerprint

Islets of Langerhans Transplantation
Insulin
Portal Vein
Cyclosporine
Blood Glucose
Clinical Trials
Transplants
Glucose
Time and Motion Studies
Antilymphocyte Serum
C-Peptide
Local Anesthesia
Type 1 Diabetes Mellitus
Cadaver
Immunosuppression
Pancreas
Fasting
Reference Values
Maintenance
Kidney

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Scharp, D. W., Lacy, P. E., Santiago, J. V., Mccullough, C. S., Weide, L. G., Falqui, L., ... Flye, M. W. (1990). Insulin independence after islet transplantation into type I diabetic patient. Diabetes, 39(4), 515-518.

Insulin independence after islet transplantation into type I diabetic patient. / Scharp, David W.; Lacy, Paul E.; Santiago, Julio V.; Mccullough, Christopher S.; Weide, Lamont G.; Falqui, Luca; Marchetti, Piero; Gingerich, Ronald L.; Jaffe, Allan S; Cryer, Philip E.; Anderson, Charles B.; Flye, M. Wayne.

In: Diabetes, Vol. 39, No. 4, 04.1990, p. 515-518.

Research output: Contribution to journalArticle

Scharp, DW, Lacy, PE, Santiago, JV, Mccullough, CS, Weide, LG, Falqui, L, Marchetti, P, Gingerich, RL, Jaffe, AS, Cryer, PE, Anderson, CB & Flye, MW 1990, 'Insulin independence after islet transplantation into type I diabetic patient', Diabetes, vol. 39, no. 4, pp. 515-518.
Scharp DW, Lacy PE, Santiago JV, Mccullough CS, Weide LG, Falqui L et al. Insulin independence after islet transplantation into type I diabetic patient. Diabetes. 1990 Apr;39(4):515-518.
Scharp, David W. ; Lacy, Paul E. ; Santiago, Julio V. ; Mccullough, Christopher S. ; Weide, Lamont G. ; Falqui, Luca ; Marchetti, Piero ; Gingerich, Ronald L. ; Jaffe, Allan S ; Cryer, Philip E. ; Anderson, Charles B. ; Flye, M. Wayne. / Insulin independence after islet transplantation into type I diabetic patient. In: Diabetes. 1990 ; Vol. 39, No. 4. pp. 515-518.
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