Successful treatment of brittle diabetes following total pancreatectomy by islet allotransplantation: a case report.

Abstract

CONTEXT:

Allotransplantation of islets can successfully treat subjects with type 1 diabetes complicated by severe hypoglycemia and erratic glycemic control. Insulin independence is often lost over time due to several factors, including recurrent autoimmunity. Brittle diabetes (frequent hypoglycemia and labile glycemic control) is common after pancreatectomy. This is ameliorated by auto-islet transplantation in pancreatectomized patients who have better glycemic control, even without insulin independence.

CASE REPORT:

We herein report a case where islet allotransplantation was carried out in a patient who had undergone total pancreatectomy. Following two islet infusions, he became insulin independent with excellent glycemic control and remains so currently, more than four years after his second islet infusion. Side effects from immunosuppressive therapy were minimal.

DISCUSSION:

Islet allotransplantation can be considered in selected individuals post-pancreatectomy. The absence of autoimmunity may be advantageous for long term graft function relative to islet allotransplantation in type 1 diabetic recipients.

• Authors: Angela Koh, Sharleen Imes, Andrew Mark James Shapiro, Peter A Senior
• Journal: JOP : Journal of the pancreas (JOP) Vol. 14 Issue 4 Pg. 428-31 (Jul 10 2013) ISSN: 1590-8577 [Electronic] Italy
• PMID: 23846941 (Publication Type: Case Reports, Journal Article)

Chemical References

• Blood Glucose

Topics

• Blood Glucose (metabolism)
• Diabetes Mellitus, Type 1 (blood, etiology, surgery)
• Humans
• Islets of Langerhans Transplantation (methods)
• Male
• Middle Aged
• Pancreatectomy (adverse effects, methods)
• Postoperative Complications (blood, etiology, surgery)
• Transplantation, Autologous
• Treatment Outcome