Abstract:
AIMS/HYPOTHESIS:Improvements in islet transplantation require clinical series large enough to implement controlled new strategies. The goal of this study was to demonstrate the feasibility of a multicentre network for islet transplantation in Type I (insulin-dependent) diabetic patients. METHODS:The five centres (Besançon, Geneva, Grenoble, Lyon, Strasbourg) of the GRAGIL network allow pancreas procurement, recipient recruitment, transplantation procedure and follow-up. Islet isolation is, however, performed in one single laboratory (Geneva). Pancreata were procured in each of the five centres and transported to Geneva with an ischaemia time of less than 8 hours. Islets were isolated using a standard automated method. If the islet number was too low for a graft (< 6,000 Islet-equivalent/kg), islets were cultured up to 12 days until another isolation was possible. Islets were transplanted by percutaneous transhepatic intraportal injection. Immunosuppression consisted of cyclosporine, mycophenolate mofetil, steroids and an anti-interleukin 2 receptor antibody. RESULTS:From March 1999 to June 2000, 56 pancreata procurements were performed with an average yield of 234500 islet-equivalent, with 32 preparations over 200000 islet-equivalent. Ten C-peptide negative Type I diabetic patients (5 men and 5 women, median age 44 years, median diabetes duration 29 years) with an established kidney graft (> 6 months) received 9,030 +/- 1,090 islet-equivalent/kg with a median purity of 63 %. The number of pancreata required for each graft was 1 (n = 5) or 2 (n = 5). At the completion of a 12 month follow-up, we observed 0% primary nonfunction, 50% graft survival and 20% insulin-independence. CONCLUSIONS/INTERPRETATION:This study demonstrates the interest and the feasibility of a multicentre collaboration in human islet transplantation.
journal_name
Diabetologiajournal_title
Diabetologiaauthors
Benhamou PY,Oberholzer J,Toso C,Kessler L,Penfornis A,Bayle F,Thivolet C,Martin X,Ris F,Badet L,Colin C,Morel P,GRAGIL consortium.doi
10.1007/s001250100571subject
Has Abstractpub_date
2001-07-01 00:00:00pages
859-64issue
7eissn
0012-186Xissn
1432-0428journal_volume
44pub_type
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