Abstract

Successful Treatment of Brittle Diabetes Following Total Pancreatectomy by Islet Allotransplantation: A Case Report

Context Allotransplantation of islets can successfully treat subjects with type 1 diabetes complicated by severehypoglycemia and erratic glycemic control. Insulin independence is often lost over time due to several factors, includingrecurrent autoimmunity. Brittle diabetes (frequent hypoglycemia and labile glycemic control) is common afterpancreatectomy. This is ameliorated by auto-islet transplantation in pancreatectomized patients who have better glycemiccontrol, even without insulin independence. Case report We herein report a case where islet allotransplantation was carriedout in a patient who had undergone total pancreatectomy. Following two islet infusions, he became insulin independent withexcellent glycemic control and remains so currently, more than four years after his second islet infusion. Side effects fromimmunosuppressive therapy were minimal. Discussion Islet allotransplantation can be considered in selected individualspost-pancreatectomy. The absence of autoimmunity may be advantageous for long term graft function relative to isletallotransplantation in type 1 diabetic recipients.


Author(s):

AM James Shapiro, Sharleen Imes, Peter A Senior, Angela Koh



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