ISLET CELL TRANSPLANTATION IN PATIENTS WITH TYPE I DIABETES

I 型糖尿病患者的胰岛细胞移植

• 批准号: 7606679
• 负责人: Kenneth Lewis Brayman
• 金额: $ 2.32万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7606679
• 关键词: Alberta province; Animal Model; Caring; Clinical; Computer Retrieval of Information on Scientific Projects Database; Diabetes Mellitus; Diagnostic; Early Diagnosis; Evaluation; Functional disorder; Funding; Grant; Hospitalization; Human; Hypoglycemia; Hypoglycemic Agents; Immunosuppression; Immunosuppressive Agents; Infusion procedures; Institution; Insulin; Intervention; Investigation; Islet Cell; Islets of Langerhans; Islets of Langerhans Transplantation; Kidney Transplantation; Liver; Monitor; Numbers; OGTT; Operative Surgical Procedures; Outcome; Patients; Pharmaceutical Preparations; Procedures; Protocols documentation; Research; Research Personnel; Resources; Source; Surgical complication; Techniques; Therapeutic immunosuppression; Transplantation; United States National Institutes of Health; Universities; Virginia; glucose monitor; improved; intravenous glucose tolerance test; islet; success; type I diabetic

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The success of pancreatic islet cell transplantation in animal models has culminated in the experimental procedure being performed in human type I diabetic human recipients. The outcome of clinical islet transplant has been variable, but more recently the majority of recipients are free from insulin therapy one year after transplantation. The avoidance of surgical complications through the percutaneous infusion of isolated islet cells into the liver promises a safer mode of transplantation and less need for post surgical care and hospitalization. The recent success of the University of Alberta when using new combinations of immunosuppressive drugs has led to new enthusiasm amongst transplant groups. This procedure, known as the Edmonton Protocol, has demonstrated improved success with a number of patients successfully remaining off insulin for over 3 years. The islet transplant protocol at the University of Virginia will focus on 3 groups of recipients, all with hypoglycemic unawareness. Non-uremic patients islet transplant alone (ITA), islet transplant after renal transplantation while patients are already taking immunosuppressants (IAK) and a simultaneous islet-kidney transplant in uremic patients (SIK). For all three groups of recipients, we hypothesize the close monitoring of islet function using continuous glucose monitoring techniques will allow early detection of islet dysfunction and more formal investigation (OGTT, IVGTT), which, if determined to be abnormal, will allow further diagnostic evaluation of donor specific reactivity and possible intervention such as exogenous insulin administration or the addition of more immunosuppression.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 胰岛细胞移植在动物模型中的成功最终在人类 I 型糖尿病接受者身上进行的实验过程中达到了顶峰。临床胰岛移植的结果各不相同，但最近大多数接受者在移植后一年无需接受胰岛素治疗。通过经皮将分离的胰岛细胞输注到肝脏中可以避免手术并发症，这有望成为一种更安全的移植方式，并减少术后护理和住院的需要。 阿尔伯塔大学最近在使用新的免疫抑制药物组合方面取得的成功引起了移植团体的新热情。这一手术被称为埃德蒙顿方案，已证明取得了更大的成功，许多患者成功地在 3 年多的时间内不再使用胰岛素。 弗吉尼亚大学的胰岛移植方案将重点关注 3 组接受者，他们都没有意识到低血糖。 非尿毒症患者单纯胰岛移植（ITA）、已服用免疫抑制剂的肾移植后胰岛移植（IAK）以及尿毒症患者同时胰岛肾移植（SIK）。 对于所有三组受者，我们假设使用连续血糖监测技术密切监测胰岛功能将有助于及早发现胰岛功能障碍并进行更正式的调查（OGTT、IVGTT），如果确定异常，将允许对供体特异性反应进行进一步的诊断评估，并可能进行干预，例如外源性胰岛素给药或添加更多免疫抑制。