open access

Vol 9, No 5 (2020)
Case report
Published online: 2020-09-17
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Pancreatic islet transplantation in a simultaneous pancreas and kidney transplant recipient — a case report

Justyna Gołębiewska, Bogumił Wolnik, Michał Hoffmann, Tomasz Gorycki, Maciej Śledziński, Karolina Gołąb, Patrycja Skowrońska, Anna Milecka, Iwona Skóra, Jacek Gulczyński, Iwona Żygowska, Piotr Witkowski, Grażyna Moszkowska, Maria Bieniaszewska, Edyta Szurowska, Zbigniew Śledziński, Tomasz Stefaniak, Alicja Dębska-Ślizień
DOI: 10.5603/DK.2020.0034
·
Clinical Diabetology 2020;9(5):338-343.

open access

Vol 9, No 5 (2020)
CASE REPORT
Published online: 2020-09-17

Abstract

Beta cell replacement allows for adequate blood glucose control, reduced progression or even reversal of microvascular complications, and improves the quality of life. Simultaneous pancreas and kidney transplantation is the best therapeutic option for patients with type 1 diabetes and end-stage renal disease resulting from diabetic nephropathy. However, when pancreas transplantation is contraindicated or unavailable, pancreatic islet transplantation is an alternative minimally invasive procedure. We report a patient after earlier simultaneous kidney and pancreas transplantation with a failed pancreas graft, and no option for pancreas retransplantation. In this patient pancreatic islet transplantation was performed. The latter resulted in an improved blood glucose control, restoration of hypoglycaemia awareness, and improved quality of life with stable good function of the kidney allograft.

Abstract

Beta cell replacement allows for adequate blood glucose control, reduced progression or even reversal of microvascular complications, and improves the quality of life. Simultaneous pancreas and kidney transplantation is the best therapeutic option for patients with type 1 diabetes and end-stage renal disease resulting from diabetic nephropathy. However, when pancreas transplantation is contraindicated or unavailable, pancreatic islet transplantation is an alternative minimally invasive procedure. We report a patient after earlier simultaneous kidney and pancreas transplantation with a failed pancreas graft, and no option for pancreas retransplantation. In this patient pancreatic islet transplantation was performed. The latter resulted in an improved blood glucose control, restoration of hypoglycaemia awareness, and improved quality of life with stable good function of the kidney allograft.
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Keywords

pancreatic islet transplantation, severe hypoglycaemia

About this article
Title

Pancreatic islet transplantation in a simultaneous pancreas and kidney transplant recipient — a case report

Journal

Clinical Diabetology

Issue

Vol 9, No 5 (2020)

Article type

Case report

Pages

338-343

Published online

2020-09-17

DOI

10.5603/DK.2020.0034

Bibliographic record

Clinical Diabetology 2020;9(5):338-343.

Keywords

pancreatic islet transplantation
severe hypoglycaemia

Authors

Justyna Gołębiewska
Bogumił Wolnik
Michał Hoffmann
Tomasz Gorycki
Maciej Śledziński
Karolina Gołąb
Patrycja Skowrońska
Anna Milecka
Iwona Skóra
Jacek Gulczyński
Iwona Żygowska
Piotr Witkowski
Grażyna Moszkowska
Maria Bieniaszewska
Edyta Szurowska
Zbigniew Śledziński
Tomasz Stefaniak
Alicja Dębska-Ślizień

References (8)
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  2. Pedersen-Bjergaard U, Pramming S, Heller SR, et al. Severe hypoglycaemia in 1076 adult patients with type 1 diabetes: influence of risk markers and selection. Diabetes Metab Res Rev. 2004; 20(6): 479–486.
  3. Rickels M, Stock P, Koning Ede, et al. Defining Outcomes for β-cell Replacement Therapy in the Treatment of Diabetes: A Consensus Report on the Igls Criteria From the IPITA/EPITA Opinion Leaders Workshop. Transplantation. 2018; 102(9): 1479–1486.
  4. Benhamou PY, Milliat-Guittard L, Wojtusciszyn A, et al. GRAGIL group. Quality of life after islet transplantation: data from the GRAGIL 1 and 2 trials. Diabet Med. 2009; 26(6): 617–621.
  5. Cure P, Pileggi A, Froud T, et al. Improved metabolic control and quality of life in seven patients with type 1 diabetes following islet after kidney transplantation. Transplantation. 2008; 85(6): 801–812.
  6. Grochowiecki T, Schmidt J. Leczenie immunosupresyjne po przeszczepianiu trzustki i wysp trzustkowych. In: Durlik M, Przybyłowski P, editors. Zalecenia dotyczące leczenia immunosupresyjnego po przeszczepieniu narządów unaczynionych. Warszawa: Fundacja Zjednoczeni dla Transplantacji. 2018: 130–142.
  7. Wojtusciszyn A, Branchereau J, Esposito L, et al. TREPID group. Indications for islet or pancreatic transplantation: Statement of the TREPID working group on behalf of the Société francophone du diabète (SFD), Société francaise d'endocrinologie (SFE), Société francophone de transplantation (SFT) and Société française de néphrologie - dialyse - transplantation (SFNDT). Diabetes Metab. 2019; 45(3): 224–237.
  8. Lablanche S, Borot S, Wojtusciszyn A, et al. GRAGIL Network. Five-Year metabolic, functional, and safety results of patients with type 1 diabetes transplanted with allogenic islets within the swiss-french GRAGIL network. Diabetes Care. 2015; 38(9): 1714–1722.

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