Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory

Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment i...

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Published in:Archives of Endocrinology and Metabolism Vol. 59; no. 2; pp. 161 - 170
Main Authors: Rheinheimer, Jakeline, Bauer, Andrea C., Silveiro, Sandra P., Estivalet, Aline A. F., Bouças, Ana P., Rosa, Annelise R., Souza, Bianca M. de, Oliveira, Fernanda S. de, Cruz, Lavínia A., Brondani, Letícia A., Azevedo, Mirela J., Lemos, Natália E., Carlessi, Rodrigo, Assmann, Taís S., Gross, Jorge L., Leitão, Cristiane B., Crispim, Daisy
Format: Journal Article
Language:English
Published: Brazil Brazilian Society of Endocrinology and Metabolism 01.04.2015
Subjects:
Brazil
Cell Separation - methods
Diabetes Mellitus, Type 1 - therapy
Facility Design and Construction - standards
Human pancreatic islets
Humans
Insulin - therapeutic use
islet isolation
islet transplantation
Islets of Langerhans
Islets of Langerhans Transplantation - economics
Islets of Langerhans Transplantation - legislation & jurisprudence
Islets of Langerhans Transplantation - trends
Laboratories - organization & administration
type 1 diabetes mellitus
Brazil
ISSN:2359-3997, 2359-4292, 2359-3997, 2359-4292
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Abstract Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with "brittle T1DM", who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and hypoglycemic perception. The Edmonton group demonstrated that most patients who received islet infusions from more than one donor and were treated with steroid-free immunosuppressive drugs displayed a considerable decline in the initial insulin independence rates at eight years following the transplantation, but showed permanent C-peptide secretion, which facilitated glycemic control and protected patients against hypoglycemic episodes. Recently, data published by the Collaborative Islet Transplant Registry (CITR) has revealed that approximately 50% of the patients who undergo islet transplantation are insulin independent after a 3-year follow-up. Therefore, islet transplantation is able to successfully decrease plasma glucose and HbA1c levels, the occurrence of severe hypoglycemia, and improve patient quality of life. The goal of this paper was to review the human islet isolation and transplantation processes, and to describe the establishment of a human islet isolation laboratory at the Endocrine Division of the Hospital de Clínicas de Porto Alegre - Rio Grande do Sul, Brazil.
AbstractList Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with "brittle T1DM", who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and hypoglycemic perception. The Edmonton group demonstrated that most patients who received islet infusions from more than one donor and were treated with steroid-free immunosuppressive drugs displayed a considerable decline in the initial insulin independence rates at eight years following the transplantation, but showed permanent C-peptide secretion, which facilitated glycemic control and protected patients against hypoglycemic episodes. Recently, data published by the Collaborative Islet Transplant Registry (CITR) has revealed that approximately 50% of the patients who undergo islet transplantation are insulin independent after a 3-year follow-up. Therefore, islet transplantation is able to successfully decrease plasma glucose and HbA1c levels, the occurrence of severe hypoglycemia, and improve patient quality of life. The goal of this paper was to review the human islet isolation and transplantation processes, and to describe the establishment of a human islet isolation laboratory at the Endocrine Division of the Hospital de Clínicas de Porto Alegre - Rio Grande do Sul, Brazil.
Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with "brittle T1DM", who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and hypoglycemic perception. The Edmonton group demonstrated that most patients who received islet infusions from more than one donor and were treated with steroid-free immunosuppressive drugs displayed a considerable decline in the initial insulin independence rates at eight years following the transplantation, but showed permanent C-peptide secretion, which facilitated glycemic control and protected patients against hypoglycemic episodes. Recently, data published by the Collaborative Islet Transplant Registry (CITR) has revealed that approximately 50% of the patients who undergo islet transplantation are insulin independent after a 3-year follow-up. Therefore, islet transplantation is able to successfully decrease plasma glucose and HbA1c levels, the occurrence of severe hypoglycemia, and improve patient quality of life. The goal of this paper was to review the human islet isolation and transplantation processes, and to describe the establishment of a human islet isolation laboratory at the Endocrine Division of the Hospital de Clínicas de Porto Alegre - Rio Grande do Sul, Brazil.Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with "brittle T1DM", who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and hypoglycemic perception. The Edmonton group demonstrated that most patients who received islet infusions from more than one donor and were treated with steroid-free immunosuppressive drugs displayed a considerable decline in the initial insulin independence rates at eight years following the transplantation, but showed permanent C-peptide secretion, which facilitated glycemic control and protected patients against hypoglycemic episodes. Recently, data published by the Collaborative Islet Transplant Registry (CITR) has revealed that approximately 50% of the patients who undergo islet transplantation are insulin independent after a 3-year follow-up. Therefore, islet transplantation is able to successfully decrease plasma glucose and HbA1c levels, the occurrence of severe hypoglycemia, and improve patient quality of life. The goal of this paper was to review the human islet isolation and transplantation processes, and to describe the establishment of a human islet isolation laboratory at the Endocrine Division of the Hospital de Clínicas de Porto Alegre - Rio Grande do Sul, Brazil.
Author Rosa, Annelise R.
Brondani, Letícia A.
Oliveira, Fernanda S. de
Bauer, Andrea C.
Azevedo, Mirela J.
Crispim, Daisy
Lemos, Natália E.
Estivalet, Aline A. F.
Bouças, Ana P.
Silveiro, Sandra P.
Carlessi, Rodrigo
Cruz, Lavínia A.
Assmann, Taís S.
Souza, Bianca M. de
Rheinheimer, Jakeline
Gross, Jorge L.
Leitão, Cristiane B.
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Snippet Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age....
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SubjectTerms Brazil
Cell Separation - methods
Diabetes Mellitus, Type 1 - therapy
Facility Design and Construction - standards
Human pancreatic islets
Humans
Insulin - therapeutic use
islet isolation
islet transplantation
Islets of Langerhans
Islets of Langerhans Transplantation - economics
Islets of Langerhans Transplantation - legislation & jurisprudence
Islets of Langerhans Transplantation - trends
Laboratories - organization & administration
type 1 diabetes mellitus
Title Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory
URI https://www.ncbi.nlm.nih.gov/pubmed/25993680
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