THU273 Sixteen Years Of Insulin Independence In A Patient With Type 1 Diabetes Mellitus Following Single-Donor Islet Cell Transplantation

• Published in: Journal of the Endocrine Society Vol. 7; no. Supplement_1
• Main Authors: Kachhadia, Palak, Khan, Shaza, Aldasouqi, Saleh, Donley, Christina, Abu Limon, Ahmad
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 05.10.2023
• Subjects: Diabetes And Glucose Metabolism
• ISSN: 2472-1972; 2472-1972
• DOI: 10.1210/jendso/bvad114.709

Abstract Disclosure: P. Kachhadia: None. S. Khan: None. S. Aldasouqi: None. C. Donley: None. A. Abu Limon: None. Introduction: Patients with Type 1 Diabetes Mellitus (T1DM) require treatment with long term insulin unless they undergo whole organ pancreatic transplant, or they undergo islet cell transplantation. Due to paucity of donors, there is a trend towards single rather double-donor islet cell transplant. There is about 50% long term viability with single-donor transplants. We are not aware of islet cells viability over 15 years. We present the case of a patient with T1DM who received single-donor islet cell transplant 16 years ago, and she is still insulin independent. Case Presentation: The patient is a 52-year-old female with T1DM who received single-donor islet cell transplantation at the University of Illinois at Chicago Hospital. She was diagnosed with T1DM at age 9 and was using an insulin pump till she received the transplant in May of 2006. She is currently not on insulin therapy and is only taking sitagliptin 100mg once daily (as a beta-cell preservative). To our knowledge, she has the longest islet cell viability from a single-donor transplant (over 16 years). Long term immunosuppressive therapy includes mycophenolate 720mg BID and Tacrolimus 1mg BID. Most recent Hemoglobin A1C is 6.6%. She only has diabetic retinopathy that she developed prior to transplant. Retinopathy has been stable and she has received laser treatments by ophthalmology. Discussion: In this procedure, islets are taken from the pancreas of a deceased organ donor. A patient often receives transplantation of around 500 000 islet cells through the use of a percutaneous catheter into the portal vein of the liver or through mini-laparotomy. Though pancreatic transplantation itself carries a higher rate of insulin independence as compared to islet cell transplantation (75% vs 57%), it is associated with higher risks of infections and hospitalizations. As per the Collaborative Islet Transplant Registry, greater than 90% of those who were experiencing hypoglycemia prior to transplantation were free of such events at follow up of 5 years. In addition, 60% of patients were able to maintain glycemic control at A1C less than 6.5%. Conclusion: In conclusion, physicians should consider islet cell transplant as a viable option for long term treatment of patients who have T1DM with difficulties of achieving glycemic control or with severe or refractory hypoglycemia. Presentation: Thursday, June 15, 2023