Human islet allotransplantation in 18 diabetic patients.

Nineteen mtrahepatic islet allografts were performed in 18 patients. In group I. nine patients aged 8 to 58 years underwent (ombined liver-Islet allotransplantation following upper-abdominal exenteration for tumors too extensive to be removed with less drastic procedures.b•7 Preliminary results on these patients have been reponed previously.~ In group 2. three type I diabetic patients aged 22 to 56 years received a combined liver-islet allograft. The indications for liver transplantation were cirrhosis secondary to hepatitis C. alcoholic cirrhosis. and cryptogenic cirrhosis. All patients had an absent C-peptide response to glucagon or Sustacal challenge test. In group 3. six patients aged 28 to 42 years received seven combined cadaveric kidney-islet grafts (one retransplant) for end-stage renal disease secondary to type I diabetes mellitus. The human islets were obtained by a modificationM of the automated method for human islet isolation. ~ The preparation was Infused into the ponal vein catheter over 20 to 30 minutes. Immunosuppression was with FK-506 (group Il and FK-506 plus steroids (groups 2 and 3), Supplementary sterOIds or OKT3 was given if rejection was suspected clinically or diagnosed by biopsy.