Long-term (>3-Year) insulin independence in a patient with pancreatic islet cell transplantation following upper abdominal exenteration and liver replacement for fibrolamellar hepatocellular carcinoma

Patricia B. Carroll, Horacio L R Rilo, Rodolfo Alejandro, Yijun Zeng, Rana Khan, Paulo Fontes, Andreas G. Tzakis, Brian Carr, Camillo Ricordi

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

In the University of Pittsburgh experience, the most successful setting for human islet allografts is in patients undergoing upper abdominal exenteration with total pancreatectomy and liver transplantation for the indication of malignancy (cluster). In this group of patients 6/11 were insulin-independent for long periods. We report herein the metabolic course or the longest survivor (>3 years). This patient has been free of exogenous insulin since the third postoperative month and has sustained her body weight without total parenteral nutrition since the 4th postoperative month. The patient has some postprandial hyperglycemia but average capillary glucoses are near-normal to normal as are glycosylated hemoglobin values. The clearance of glucose during the administration of an intravenous glucose load has been well preserved and is currently normal. C-peptide stimulates significantly in response to intravenously injected glucose. The absolute levels of stimulation during the test have declined possibly related to improvements in renal function, decreased immunosuppression or the natural history of cells transplanted into the portal site. The kinetics of the C-peptide response to intravenously injected glucose shows a persistent abnormality of first-phase insulin release and a prolonged second phase release. Basal glucagon levels are low but stimulate to a mixed meal. This patient’s results demonstrate long-term function of islet cells from a single donor transplanted into the portal vein using FK506 as an immunosuppressant agent.

Original languageEnglish
Pages (from-to)875-879
Number of pages5
JournalTransplantation
Volume59
Issue number6
Publication statusPublished - Mar 27 1995

Fingerprint

Islets of Langerhans Transplantation
Cell Transplantation
Islets of Langerhans
Insulin
Glucose
Liver
C-Peptide
Pancreatectomy
Total Parenteral Nutrition
Glycosylated Hemoglobin A
Tacrolimus
Immunosuppressive Agents
Portal Vein
Natural History
Glucagon
Hyperglycemia
Intravenous Administration
Liver Transplantation
Immunosuppression
Allografts

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Long-term (>3-Year) insulin independence in a patient with pancreatic islet cell transplantation following upper abdominal exenteration and liver replacement for fibrolamellar hepatocellular carcinoma. / Carroll, Patricia B.; Rilo, Horacio L R; Alejandro, Rodolfo; Zeng, Yijun; Khan, Rana; Fontes, Paulo; Tzakis, Andreas G.; Carr, Brian; Ricordi, Camillo.

In: Transplantation, Vol. 59, No. 6, 27.03.1995, p. 875-879.

Research output: Contribution to journalArticle

Carroll, Patricia B. ; Rilo, Horacio L R ; Alejandro, Rodolfo ; Zeng, Yijun ; Khan, Rana ; Fontes, Paulo ; Tzakis, Andreas G. ; Carr, Brian ; Ricordi, Camillo. / Long-term (>3-Year) insulin independence in a patient with pancreatic islet cell transplantation following upper abdominal exenteration and liver replacement for fibrolamellar hepatocellular carcinoma. In: Transplantation. 1995 ; Vol. 59, No. 6. pp. 875-879.
@article{d9ce2796ff45425fa611f1691e5fef3f,
title = "Long-term (>3-Year) insulin independence in a patient with pancreatic islet cell transplantation following upper abdominal exenteration and liver replacement for fibrolamellar hepatocellular carcinoma",
abstract = "In the University of Pittsburgh experience, the most successful setting for human islet allografts is in patients undergoing upper abdominal exenteration with total pancreatectomy and liver transplantation for the indication of malignancy (cluster). In this group of patients 6/11 were insulin-independent for long periods. We report herein the metabolic course or the longest survivor (>3 years). This patient has been free of exogenous insulin since the third postoperative month and has sustained her body weight without total parenteral nutrition since the 4th postoperative month. The patient has some postprandial hyperglycemia but average capillary glucoses are near-normal to normal as are glycosylated hemoglobin values. The clearance of glucose during the administration of an intravenous glucose load has been well preserved and is currently normal. C-peptide stimulates significantly in response to intravenously injected glucose. The absolute levels of stimulation during the test have declined possibly related to improvements in renal function, decreased immunosuppression or the natural history of cells transplanted into the portal site. The kinetics of the C-peptide response to intravenously injected glucose shows a persistent abnormality of first-phase insulin release and a prolonged second phase release. Basal glucagon levels are low but stimulate to a mixed meal. This patient’s results demonstrate long-term function of islet cells from a single donor transplanted into the portal vein using FK506 as an immunosuppressant agent.",
author = "Carroll, {Patricia B.} and Rilo, {Horacio L R} and Rodolfo Alejandro and Yijun Zeng and Rana Khan and Paulo Fontes and Tzakis, {Andreas G.} and Brian Carr and Camillo Ricordi",
year = "1995",
month = "3",
day = "27",
language = "English",
volume = "59",
pages = "875--879",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Long-term (>3-Year) insulin independence in a patient with pancreatic islet cell transplantation following upper abdominal exenteration and liver replacement for fibrolamellar hepatocellular carcinoma

AU - Carroll, Patricia B.

AU - Rilo, Horacio L R

AU - Alejandro, Rodolfo

AU - Zeng, Yijun

AU - Khan, Rana

AU - Fontes, Paulo

AU - Tzakis, Andreas G.

AU - Carr, Brian

AU - Ricordi, Camillo

PY - 1995/3/27

Y1 - 1995/3/27

N2 - In the University of Pittsburgh experience, the most successful setting for human islet allografts is in patients undergoing upper abdominal exenteration with total pancreatectomy and liver transplantation for the indication of malignancy (cluster). In this group of patients 6/11 were insulin-independent for long periods. We report herein the metabolic course or the longest survivor (>3 years). This patient has been free of exogenous insulin since the third postoperative month and has sustained her body weight without total parenteral nutrition since the 4th postoperative month. The patient has some postprandial hyperglycemia but average capillary glucoses are near-normal to normal as are glycosylated hemoglobin values. The clearance of glucose during the administration of an intravenous glucose load has been well preserved and is currently normal. C-peptide stimulates significantly in response to intravenously injected glucose. The absolute levels of stimulation during the test have declined possibly related to improvements in renal function, decreased immunosuppression or the natural history of cells transplanted into the portal site. The kinetics of the C-peptide response to intravenously injected glucose shows a persistent abnormality of first-phase insulin release and a prolonged second phase release. Basal glucagon levels are low but stimulate to a mixed meal. This patient’s results demonstrate long-term function of islet cells from a single donor transplanted into the portal vein using FK506 as an immunosuppressant agent.

AB - In the University of Pittsburgh experience, the most successful setting for human islet allografts is in patients undergoing upper abdominal exenteration with total pancreatectomy and liver transplantation for the indication of malignancy (cluster). In this group of patients 6/11 were insulin-independent for long periods. We report herein the metabolic course or the longest survivor (>3 years). This patient has been free of exogenous insulin since the third postoperative month and has sustained her body weight without total parenteral nutrition since the 4th postoperative month. The patient has some postprandial hyperglycemia but average capillary glucoses are near-normal to normal as are glycosylated hemoglobin values. The clearance of glucose during the administration of an intravenous glucose load has been well preserved and is currently normal. C-peptide stimulates significantly in response to intravenously injected glucose. The absolute levels of stimulation during the test have declined possibly related to improvements in renal function, decreased immunosuppression or the natural history of cells transplanted into the portal site. The kinetics of the C-peptide response to intravenously injected glucose shows a persistent abnormality of first-phase insulin release and a prolonged second phase release. Basal glucagon levels are low but stimulate to a mixed meal. This patient’s results demonstrate long-term function of islet cells from a single donor transplanted into the portal vein using FK506 as an immunosuppressant agent.

UR - http://www.scopus.com/inward/record.url?scp=0028966354&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028966354&partnerID=8YFLogxK

M3 - Article

C2 - 7701583

AN - SCOPUS:0028966354

VL - 59

SP - 875

EP - 879

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 6

ER -