Risks and side effects of islet transplantation

被引：78

作者：

Ryan E.A. ^{[1
]}

Paty B.W. ^{[1
]}

Senior P.A. ^{[1
]}

Shapiro A.M.J. ^{[1
]}

机构：

[1] Clinical Islet Transplant Program, Edmonton, Alta. T6G 2C8

来源：

Current Diabetes Reports | 2004年 / 4卷 / 4期

关键词：

Tacrolimus; Hypoglycemia; Sirolimus; Portal Vein Thrombosis; Islet Transplantation;

D O I：

10.1007/s11892-004-0083-8

中图分类号：

学科分类号：

摘要：

Islet transplantation can deliver stable glycemic control, relief from recurrent severe hypoglycemia, and insulin independence. Accessing the portal vein via the percutaneous hepatic approach carries the risk of bleeding, and the infusion of islets a risk of portal vein thrombosis. In the long term, common minor problems with immunosuppression are mouth ulcers, diarrhea, and acne. Longer-term risks include malignancy and serious infection, both rare to date in clinical islet transplantation. Sensitization to donor antigens may also occur. The long-term diabetes complications may stabilize, but of this aspect little is known to date. In the short term, there may be some elevation of serum cholesterol and blood pressure, in some patients there has been a decline in renal function, and in a few, acute retinal bleeds. For most, improvement in glucose control with resolution of glycemic lability and hypoglycemia, has been a net benefit Copyright © 2004 by Current Science Inc.

引用

页码：304 / 309

页数：5

共 55 条

[1]

Goss J.A., Soltes G., Goodpastor S.E., Et al., Pancreatic islet transplantation: The radiographic approach, Transplantation, 76, pp. 199-203, (2003)

[2]

Owen R.J., Ryan E.A., O'Kelly K., Et al., Percutaneous transhepatic pancreatic islet cell transplantation in type 1 diabetes mellitus: Radiologic aspects, Radiology, 229, pp. 165-170, (2003)

[3]

Hering B.J., Kandaswamy R., Harmon J.V., Et al., Transplantation of cultured islets from two-layer preserved pancreases in type 1 diabetes with anti-CD3 antibody, Am. J. Transplant., 4, pp. 390-401, (2004)

[4]

Ryan E.A., Shandro T., Green K., Et al., Assessment of the severity of hypoglycemia and glycemic lability in type 1 diabetic subjects undergoing islet transplantation, Diabetes, 53, pp. 955-962, (2004)

[5]

Kessler L., Passemard R., Oberholzer J., Et al., Reduction of blood glucose variability in type 1 diabetic patients treated by pancreatic islet transplantation, Diabetes Care, 25, pp. 2256-2262, (2002)

[6]

Shapiro A.M.J., Lakey J.R.T., Ryan E.A., Et al., Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen, N. Engl. J. Med., 343, pp. 230-238, (2000)

[7]

Hirshberg B., Rother K.I., Digon III B.J., Et al., Benefits and risks of solitary islet transplantation for type 1 diabetes using steroid-sparing immunosuppression, Diabetes Care, 26, pp. 3288-3295, (2003)

[8]

Ryan E.A., Lakey J.R.T., Rajotte R.V., Et al., Clinical outcomes and insulin secretion after islet transplantation with the Edmonton Protocol, Diabetes, 50, pp. 710-719, (2001)

[9]

Markmann J.F., Deng S., Huang X., Et al., Insulin independence following isolated islet transplantation and single islet infusions, Ann. Surg., 237, pp. 741-750, (2003)

[10]

Fiorina P., Folli F., Maffi F., Et al., Islet transplantation improves vascular diabetic complications in patients with diabetes who underwent kidney transplantation: A comparison between kidney-pancreas and kidney-alone transplantation, Transplantation, 75, pp. 1296-1301, (2003)

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