Reversal of Hypoglycemia Unawareness with a Single-donor, Marginal Dose Allogeneic Islet Transplantation in Korea: A Case Report.

Abstract

Pancreatic islet transplantation is a physiologically advantageous and minimally invasive procedure for the treatment of type 1 diabetes mellitus. Here, we describe the first reported case of successful allogeneic islet transplantation alone, using single-donor, marginal-dose islets in a Korean patient. A 59-yr-old patient with type 1 diabetes mellitus, who suffered from recurrent severe hypoglycemia, received 4,163 islet equivalents/kg from a single brain-death donor. Isolated islets were infused intraportally without any complications. The immunosuppressive regimen was based on the Edmonton protocol, but the maintenance dosage was reduced because of mucositis and leukopenia. Although insulin independence was not achieved, the patient showed stabilized blood glucose concentration, reduced insulin dosage and reversal of hypoglycemic unawareness, even with marginal dose of islets and reduced immunosuppressant. Islet transplantation may successfully improve endogenous insulin production and glycemic stability in subjects with type 1 diabetes mellitus.

• Authors: Hae Kyung Yang, Dong-Sik Ham, Heon-Seok Park, Marie Rhee, Young Hye You, Min Jung Kim, Ji-Won Kim, Seung-Hwan Lee, Tae Ho Hong, Byung Gil Choi, Jae Hyoung Cho, Kun-Ho Yoon
• Journal: Journal of Korean medical science (J Korean Med Sci) Vol. 30 Issue 7 Pg. 991-4 (Jul 2015) ISSN: 1598-6357 [Electronic] Korea (South)
• PMID: 26130966 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Immunosuppressive Agents

Topics

• Blood Glucose (analysis)
• Diabetes Mellitus, Type 1 (surgery)
• Female
• Humans
• Hypoglycemia (surgery)
• Immunosuppression Therapy (methods)
• Immunosuppressive Agents (therapeutic use)
• Islets of Langerhans (physiology, surgery)
• Islets of Langerhans Transplantation (methods)
• Middle Aged
• Republic of Korea
• Tissue Donors