The favorable outcome of human islet transplantation in Korea: Experiences of 10 autologous transplantations

Byung Wan 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

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Lee, B. W., Jee, J. H., Heo, J. S., Choi, S. H., Jang, K. T., Noh, J. H., Jeong, I. K., Oh, S. H., Ahn, Y. R., Chae, H. Y., Min, Y. K., Chung, J. H., Lee, M. K., Lee, M. S., & Kim, K. W. (2005). The favorable outcome of human islet transplantation in Korea: Experiences of 10 autologous transplantations. Transplantation, 79(11), 1568-1574. https://doi.org/10.1097/01.TP.0000158427.07084.C5