2011 - IPITA - Prague


This page contains exclusive content for the member of the following sections: TTS, IPITA. Log in to view.

Parallel session 10 – Open oral presentations Topic: Clinical islet transplantation: New frontiers

10.5 - Microencapsulated neonatal porcine islet implants alleviate unaware hypoglycaemia without immune suppression

Presenter: B., Elliott, Auckland, New Zealand
Authors: B. Elliott

Microencapsulated neonatal porcine islet implants alleviate unaware hypoglycaemia without immune suppression


B. Elliott
LCT, Auckland, New Zealand

Unaware hypoglycaemia occurs in up to 20% of Type 1 diabetics and may be responsible for 8% of deaths in this group. It has been shown that partial restoration of insulin production by human islet intra-hepatic transplantation with immune-suppression can restore awareness. We describe the effects of porcine islet implantation without immune-suppression on this important iatrogenic complication of the disease. Alginate/polyornithine/alginate microencapsulated neonatal porcine islets were implanted into the peritoneal cavity of 14 adult Type 1 diabetic patients with unstable diabetes, after a two month pre-implant intensified treatment and observation. The trial was approved by the relevant ethical and scientific bodies in New Zealand. The dose of islets was escalated from 5.000/kg to 20,000/kg. Diabetes control was assessed by 7/day blood glucose determinations with intermittent periods of continuous glucose monitoring, and HbA1c measurements and a standardized record of hypoglycaemic episodes. Daily insulin requirements were recorded as daily average/week. Insulin measured by a validated quantitative HPLC method specific for porcine insulin. In addition pre and post transplant counter-regulatory hormonal responses to a standardized insulin induced hypoglycaemic episode were measured. Average results to date over a year are shown for the lower dosed patients shown below. Most notable is the dramatic reduction in unaware hypoglycaemia despite only modest reduction in insulin dose and little change in high blood glucose related data.

Parameters

Pre Tx

Post- Tx

Up to Week 12

Up to Week 12 - 52

Insulin Dose Weekly Average

41

36

30

Hypo Score (Weekly Average - Severity Indicator)

20

12

8

Number of Unaware Hypos (Weekly Average)

3.2

1.5

0.8

HbA1c (%)

7.5

7.5

7.6

Blood GLucose in Euglycaemic Range (% of time)

57

57

58

This low dose islet xenotransplantation procedure without immune suppression appears to be effective in alleviating unaware hypoglycaemia, despite only modest reduction in insulin dose.


Important Disclaimer

By viewing the material on this site you understand and accept that:

  1. The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
  2. The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
  3. The material is solely for educational purposes for qualified health care professionals.
  4. The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
  5. The information cannot be used as a substitute for professional care.
  6. The information does not represent a standard of care.
  7. No physician-patient relationship is being established.

Social

Contact

Staff Directory
+1-514-874-1717
info@tts.org

Address

The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada