Islet Allotransplantation in the Bone Marrow of Patients With Type 1 Diabetes: A Pilot Randomized Trial.
Transplantation
; 103(4): 839-851, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-30130323
ABSTRACT
BACKGROUND:
Results in murine and nonhuman primate suggested that the bone marrow (BM) might be an alternative site for pancreatic islet transplantation.METHODS:
We report the results of 2 clinical studies in patients with type 1 diabetes receiving an intra-BM allogeneic islet transplantation a feasibility study in patients with hepatic contraindications for liver islet allotransplantation receiving a single intra-BM islet infusion (n = 4) and a pilot randomized trial (11 allocation using blocks of size 6) in which patients were randomized to receive islets into either the liver (n = 6) or BM (n = 3) to evaluate islet transplant function and survival.RESULTS:
We observed no adverse events related to the intrabone injection procedure or the presence of islets in the BM. None of the recipient of an intra-BM allogeneic islet transplantation had a primary nonfunction, as shown by measurable posttransplantation C-peptide levels and histopathological evidence of insulin-producing cells or molecular markers of endocrine tissue in BM biopsy samples collected during follow-up. All patients receiving islets in the BM except 1 lost islet function during the first 4 months after infusion (2 with an early graft loss). Based on biopsies and immunomonitoring, we concluded that the islet loss was primarily caused by the recurrence of autoimmunity.CONCLUSIONS:
Bone marrow is not a suitable alternative site for pancreatic islet allotransplantation in patients with type 1 diabetes.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Medula Óssea
/
Transplante das Ilhotas Pancreáticas
/
Diabetes Mellitus Tipo 1
Tipo de estudo:
Clinical_trials
Limite:
Humans
Idioma:
En
Revista:
Transplantation
Ano de publicação:
2019
Tipo de documento:
Article