Implantation of pancreatic islets in arteriolar epiploic flap. Preliminary note on 3 cases

Presently, no long-term insulin withdrawal after islet graft in a diabetic patient has been reported. From October 1988 to December 1989 we have performed 3 pancreatic islet grafts in 3 type I diabetic patients. Islets were isolated from pancreatic glands collected during multiple organs harvesting....

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Published inChirurgie (Paris) Vol. 116; no. 3; p. 268
Main Authors Cugnenc, P H, Bethoux, J P, Altman, J J, Bismuth, H, Wind, P, Drevillon, C, Tessier, C, Moulonguet, L, Chrétien, Y
Format Journal Article
LanguageFrench
Published France 1990
Subjects
Adult
Arterioles
Diabetes Mellitus, Type 1 - surgery
Humans
Islets of Langerhans Transplantation - methods
Kidney Transplantation
Liver Transplantation
Omentum - blood supply
Omentum - surgery
Pancreas Transplantation - methods
Surgical Flaps
Transplantation, Homologous
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Summary:Presently, no long-term insulin withdrawal after islet graft in a diabetic patient has been reported. From October 1988 to December 1989 we have performed 3 pancreatic islet grafts in 3 type I diabetic patients. Islets were isolated from pancreatic glands collected during multiple organs harvesting. Implantation was conducted in an original site, by an arteriolar embolization of an epiploic flap pedicled from the right gastroepiploic vessels. Those grafts were combined twice with a kidney and in one occasion with a liver transplant. After 15 months, this last case is an unique metabolic success with complete insulino-independence. Endogenous insulin-secretion determined by C-peptide measurement was not detectable before surgery but was normalized and stimulable 6 months after the graft. Insulin injections were stopped one month later. Blood glucose is fully normal since 8 months without insulin. For the two other cases with kidney transplants after two months, endogenous insulin is already detectable. Compared with 3 segmental pancreatic grafts performed during the same period, islet graft in diabetic patients appears as a promising approach.
ISSN:0001-4001