P-213

Human islet transplantation: an overview and long-term benefits in the past 20 years

A.L.F. Lauletta, E. Chaib, R.D.L. Oliveira, L.A.C. D´Albuquerque
University of São Paulo Medical School, Department of Gastroenterology, São Paulo, Brazil

Objective: Islet Transplantation has both the potential to improve the quality of life in type 1 diabetic patients and to make them insulin-free for the longest time possible. We aim to analyze the improvements and long-term benefits in the past 20 years.

Methods: We reviewed 27 papers from 1990 to 2010, and we analyzed the number of patients, islet survival rate (ISR) and immunosuppression protocol. Up to 2000, the protocol used was based on prednisone, cyclosporine, azathioprine and antilymphocyte globulin, and from 2001 onwards, the Edmonton protocol was applied, based on corticoids-free, sirolimus,tacrolimus and daclizumab. We also studied islet auto-transplantation.

Results: From 1990 to 2000 we analyzed 13 papers witha total of 86 patients. Thirty-nine patients were insulin-free, it means ISR on 37 patients ranged from 22 days to one year; other 2 patients ISR was 3 years;22 patients the islet transplantation failed; 3 have died and 22 others had either low metabolism effect (peptide C positive) or even were not mentioned. From 2001 to 2010 we analyzed 14 papers with a total of 323 patients. There were 23 patients insulin-free with ISR ranging from 24 days to one year; other 11 patients with ISR of 18 months; 16 patients - 2 years; 22 patients - 3 years and 78 patients have either lost the graft or decreased the insulin-dependence.There were 173 patients submitted to islet auto-transplantation. The longest ISR in islet auto-transplantation was 5-years.

Conclusions: Although islet transplantation is not a procedure that provides the cure for type 1 diabetes, it can make its recipients insulin-free for a period that range from 1 to 3 year in islet allo-transplantation. The results over the past 20 years have showed that the introduction of the Edmonton protocol was a remarkable landmark, benefiting its recipient quality of life.

P-213

Human islet transplantation: an overview and long-term benefits in the past 20 years

A.L.F. Lauletta, E. Chaib, R.D.L. Oliveira, L.A.C. D´Albuquerque
University of São Paulo Medical School, Department of Gastroenterology, São Paulo, Brazil

Objective: Islet Transplantation has both the potential to improve the quality of life in type 1 diabetic patients and to make them insulin-free for the longest time possible. We aim to analyze the improvements and long-term benefits in the past 20 years.

Methods: We reviewed 27 papers from 1990 to 2010, and we analyzed the number of patients, islet survival rate (ISR) and immunosuppression protocol. Up to 2000, the protocol used was based on prednisone, cyclosporine, azathioprine and antilymphocyte globulin, and from 2001 onwards, the Edmonton protocol was applied, based on corticoids-free, sirolimus,tacrolimus and daclizumab. We also studied islet auto-transplantation.

Results: From 1990 to 2000 we analyzed 13 papers witha total of 86 patients. Thirty-nine patients were insulin-free, it means ISR on 37 patients ranged from 22 days to one year; other 2 patients ISR was 3 years;22 patients the islet transplantation failed; 3 have died and 22 others had either low metabolism effect (peptide C positive) or even were not mentioned. From 2001 to 2010 we analyzed 14 papers with a total of 323 patients. There were 23 patients insulin-free with ISR ranging from 24 days to one year; other 11 patients with ISR of 18 months; 16 patients - 2 years; 22 patients - 3 years and 78 patients have either lost the graft or decreased the insulin-dependence.There were 173 patients submitted to islet auto-transplantation. The longest ISR in islet auto-transplantation was 5-years.

Conclusions: Although islet transplantation is not a procedure that provides the cure for type 1 diabetes, it can make its recipients insulin-free for a period that range from 1 to 3 year in islet allo-transplantation. The results over the past 20 years have showed that the introduction of the Edmonton protocol was a remarkable landmark, benefiting its recipient quality of life.