Abstract
OBJECTIVE: Transplantation of insulin-producing cells placed inside
microcapsules is being trialled to overcome the need for immunosuppressive
therapy. RESEARCH DESIGN AND METHODS: Four type 1 diabetic patients
with no detectable C-peptide received an intraperitoneal infusion
of islets inside microcapsules of barium alginate (mean 178,200 islet
equivalents on each of eight occasions). RESULTS: C-peptide was detected
on day 1 post-transplantation, and blood glucose levels and insulin
requirements decreased. C-peptide was undetectable by 1-4 weeks.
In a multi-islet recipient, C-peptide was detected at 6 weeks after
the third infusion and remains detectable at 2.5 years. Neither insulin
requirements nor glycemic control was affected. Capsules recovered
at 16 months were surrounded by fibrous tissue and contained necrotic
islets. No major side effects or infection occurred. CONCLUSIONS:
While allografting of encapsulated human islets is safe, efficacy
of the cells needs to improve for the therapy to make an impact on
the clinical scene.
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