The favorable outcome of human islet transplantation in Korea

Experiences of 10 autologous transplantations

byungwan lee, Jae Hwan Jee, Jin Seok Heo, Seong Ho Choi, Kee Taek Jang, Jung Hyun Noh, In Kung Jeong, Seung Hoon Oh, You Ran Ahn, Hee Young Chae, Yong Ki Min, Jae Hoon Chung, Moon Kyu Lee, Myung Shik Lee, Kwang Won Kim

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background. Cystic neoplasms of the pancreas are an increasingly diagnosed entity, and surgical resection of the pancreas is advocated. Islet autotransplantation is a therapeutic approach used to prevent diabetes in cases of pathologically benign neoplasm after major pancreatectomy. Methods. A total of 10 patients underwent pancreatectomy with islet autotransplantation. To evaluate islet transplantation efficiency, the authors compared 23 subjects who did not undergo islet transplantation after partial pancreatectomy with 87 subjects with normal glucose tolerance and with 77 diabetic subjects that did not undergo pancreatectomy. Results. Ten female patients with nine cystic neoplasms and one patient with pancreatic injury underwent transplantation. Their mean islet equivalents (IEQ) was 3,159 IEQ/kg. During follow-up, two recipients required insulin or oral agents. At the 12-month follow-up, homeostasis model assessment (HOMA)-β was 77.36 ± 17.68, the insulinogenic index (INSindex) was 0.49 ± 0.11, and fasting C-peptide and hemoglobin A1c were 1.28 ± 0.18 ng/mL and 5.73 ± 0.26%, respectively. Islet replacement was found to increase HOMA-β by approximately 17% compared with distal pancreatectomy in normal glucose tolerance subjects without islet autotransplantation and by 46% compared with distal pancreatectomy diabetes subjects without islet autotransplantation. Factors different in the two insulin and oral hypoglycemic agent (OHA)-requiring recipients and the eight insulin- and OHA-free recipients were pancreatectomy extent, preoperative glucose metabolism insufficiency, age, and underlying cystic neoplasm disease. Conclusions. Even partial islet graft function can have a beneficial metabolic effect on the recipient in terms of metabolic parameters such as HOMA-β and INSindex. This study suggests that islet replacement should be considered for experimental procedures in benign pancreatic conditions.

Original languageEnglish
Pages (from-to)1568-1574
Number of pages7
JournalTransplantation
Volume79
Issue number11
DOIs
Publication statusPublished - 2005 Jun 15

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Islets of Langerhans Transplantation
Pancreatectomy
Autologous Transplantation
Korea
Homeostasis
Insulin
Hypoglycemic Agents
Glucose
Neoplasms
C-Peptide
Pancreatic Neoplasms
Pancreas
Fasting
Hemoglobins
Transplantation
Transplants
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

lee, byungwan ; Jee, Jae Hwan ; Heo, Jin Seok ; Choi, Seong Ho ; Jang, Kee Taek ; Noh, Jung Hyun ; Jeong, In Kung ; Oh, Seung Hoon ; Ahn, You Ran ; Chae, Hee Young ; Min, Yong Ki ; Chung, Jae Hoon ; Lee, Moon Kyu ; Lee, Myung Shik ; Kim, Kwang Won. / The favorable outcome of human islet transplantation in Korea : Experiences of 10 autologous transplantations. In: Transplantation. 2005 ; Vol. 79, No. 11. pp. 1568-1574.
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title = "The favorable outcome of human islet transplantation in Korea: Experiences of 10 autologous transplantations",
abstract = "Background. Cystic neoplasms of the pancreas are an increasingly diagnosed entity, and surgical resection of the pancreas is advocated. Islet autotransplantation is a therapeutic approach used to prevent diabetes in cases of pathologically benign neoplasm after major pancreatectomy. Methods. A total of 10 patients underwent pancreatectomy with islet autotransplantation. To evaluate islet transplantation efficiency, the authors compared 23 subjects who did not undergo islet transplantation after partial pancreatectomy with 87 subjects with normal glucose tolerance and with 77 diabetic subjects that did not undergo pancreatectomy. Results. Ten female patients with nine cystic neoplasms and one patient with pancreatic injury underwent transplantation. Their mean islet equivalents (IEQ) was 3,159 IEQ/kg. During follow-up, two recipients required insulin or oral agents. At the 12-month follow-up, homeostasis model assessment (HOMA)-β was 77.36 ± 17.68, the insulinogenic index (INSindex) was 0.49 ± 0.11, and fasting C-peptide and hemoglobin A1c were 1.28 ± 0.18 ng/mL and 5.73 ± 0.26{\%}, respectively. Islet replacement was found to increase HOMA-β by approximately 17{\%} compared with distal pancreatectomy in normal glucose tolerance subjects without islet autotransplantation and by 46{\%} compared with distal pancreatectomy diabetes subjects without islet autotransplantation. Factors different in the two insulin and oral hypoglycemic agent (OHA)-requiring recipients and the eight insulin- and OHA-free recipients were pancreatectomy extent, preoperative glucose metabolism insufficiency, age, and underlying cystic neoplasm disease. Conclusions. Even partial islet graft function can have a beneficial metabolic effect on the recipient in terms of metabolic parameters such as HOMA-β and INSindex. This study suggests that islet replacement should be considered for experimental procedures in benign pancreatic conditions.",
author = "byungwan lee and Jee, {Jae Hwan} and Heo, {Jin Seok} and Choi, {Seong Ho} and Jang, {Kee Taek} and Noh, {Jung Hyun} and Jeong, {In Kung} and Oh, {Seung Hoon} and Ahn, {You Ran} and Chae, {Hee Young} and Min, {Yong Ki} and Chung, {Jae Hoon} and Lee, {Moon Kyu} and Lee, {Myung Shik} and Kim, {Kwang Won}",
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lee, B, Jee, JH, Heo, JS, Choi, SH, Jang, KT, Noh, JH, Jeong, IK, Oh, SH, Ahn, YR, Chae, HY, Min, YK, Chung, JH, Lee, MK, Lee, MS & Kim, KW 2005, 'The favorable outcome of human islet transplantation in Korea: Experiences of 10 autologous transplantations', Transplantation, vol. 79, no. 11, pp. 1568-1574. https://doi.org/10.1097/01.TP.0000158427.07084.C5

The favorable outcome of human islet transplantation in Korea : Experiences of 10 autologous transplantations. / lee, byungwan; Jee, Jae Hwan; Heo, Jin Seok; Choi, Seong Ho; Jang, Kee Taek; Noh, Jung Hyun; Jeong, In Kung; Oh, Seung Hoon; Ahn, You Ran; Chae, Hee Young; Min, Yong Ki; Chung, Jae Hoon; Lee, Moon Kyu; Lee, Myung Shik; Kim, Kwang Won.

In: Transplantation, Vol. 79, No. 11, 15.06.2005, p. 1568-1574.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The favorable outcome of human islet transplantation in Korea

T2 - Experiences of 10 autologous transplantations

AU - lee, byungwan

AU - Jee, Jae Hwan

AU - Heo, Jin Seok

AU - Choi, Seong Ho

AU - Jang, Kee Taek

AU - Noh, Jung Hyun

AU - Jeong, In Kung

AU - Oh, Seung Hoon

AU - Ahn, You Ran

AU - Chae, Hee Young

AU - Min, Yong Ki

AU - Chung, Jae Hoon

AU - Lee, Moon Kyu

AU - Lee, Myung Shik

AU - Kim, Kwang Won

PY - 2005/6/15

Y1 - 2005/6/15

N2 - Background. Cystic neoplasms of the pancreas are an increasingly diagnosed entity, and surgical resection of the pancreas is advocated. Islet autotransplantation is a therapeutic approach used to prevent diabetes in cases of pathologically benign neoplasm after major pancreatectomy. Methods. A total of 10 patients underwent pancreatectomy with islet autotransplantation. To evaluate islet transplantation efficiency, the authors compared 23 subjects who did not undergo islet transplantation after partial pancreatectomy with 87 subjects with normal glucose tolerance and with 77 diabetic subjects that did not undergo pancreatectomy. Results. Ten female patients with nine cystic neoplasms and one patient with pancreatic injury underwent transplantation. Their mean islet equivalents (IEQ) was 3,159 IEQ/kg. During follow-up, two recipients required insulin or oral agents. At the 12-month follow-up, homeostasis model assessment (HOMA)-β was 77.36 ± 17.68, the insulinogenic index (INSindex) was 0.49 ± 0.11, and fasting C-peptide and hemoglobin A1c were 1.28 ± 0.18 ng/mL and 5.73 ± 0.26%, respectively. Islet replacement was found to increase HOMA-β by approximately 17% compared with distal pancreatectomy in normal glucose tolerance subjects without islet autotransplantation and by 46% compared with distal pancreatectomy diabetes subjects without islet autotransplantation. Factors different in the two insulin and oral hypoglycemic agent (OHA)-requiring recipients and the eight insulin- and OHA-free recipients were pancreatectomy extent, preoperative glucose metabolism insufficiency, age, and underlying cystic neoplasm disease. Conclusions. Even partial islet graft function can have a beneficial metabolic effect on the recipient in terms of metabolic parameters such as HOMA-β and INSindex. This study suggests that islet replacement should be considered for experimental procedures in benign pancreatic conditions.

AB - Background. Cystic neoplasms of the pancreas are an increasingly diagnosed entity, and surgical resection of the pancreas is advocated. Islet autotransplantation is a therapeutic approach used to prevent diabetes in cases of pathologically benign neoplasm after major pancreatectomy. Methods. A total of 10 patients underwent pancreatectomy with islet autotransplantation. To evaluate islet transplantation efficiency, the authors compared 23 subjects who did not undergo islet transplantation after partial pancreatectomy with 87 subjects with normal glucose tolerance and with 77 diabetic subjects that did not undergo pancreatectomy. Results. Ten female patients with nine cystic neoplasms and one patient with pancreatic injury underwent transplantation. Their mean islet equivalents (IEQ) was 3,159 IEQ/kg. During follow-up, two recipients required insulin or oral agents. At the 12-month follow-up, homeostasis model assessment (HOMA)-β was 77.36 ± 17.68, the insulinogenic index (INSindex) was 0.49 ± 0.11, and fasting C-peptide and hemoglobin A1c were 1.28 ± 0.18 ng/mL and 5.73 ± 0.26%, respectively. Islet replacement was found to increase HOMA-β by approximately 17% compared with distal pancreatectomy in normal glucose tolerance subjects without islet autotransplantation and by 46% compared with distal pancreatectomy diabetes subjects without islet autotransplantation. Factors different in the two insulin and oral hypoglycemic agent (OHA)-requiring recipients and the eight insulin- and OHA-free recipients were pancreatectomy extent, preoperative glucose metabolism insufficiency, age, and underlying cystic neoplasm disease. Conclusions. Even partial islet graft function can have a beneficial metabolic effect on the recipient in terms of metabolic parameters such as HOMA-β and INSindex. This study suggests that islet replacement should be considered for experimental procedures in benign pancreatic conditions.

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