Islet Cell Transplantation in Australia: Screening, Remote Transplantation, and Incretin Hormone Secretion in Insulin Independent Patients

C. S. Marathe; C. J. Drogemuller; J. A. Marathe; T. Loudavaris; W. J. Hawthorne; P. J. O’Connell; T. Radford; T. W. H. Kay; M. Horowitz; P. T. Coates; D. J. Torpy

doi:10.1055/s-0034-1389941

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2015; 47(01): 16-23
DOI: 10.1055/s-0034-1389941

Review

Islet Cell Transplantation in Australia: Screening, Remote Transplantation, and Incretin Hormone Secretion in Insulin Independent Patients

Authors

C. S. Marathe

¹Endocrine & Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia
C. J. Drogemuller

²Central Northern Adelaide Renal and Transplantation Service, and University of Adelaide at Royal Adelaide Hospital, Adelaide, Australia
J. A. Marathe

³Department of Medicine, The Queen Elizabeth Hospital, Adelaide, Australia
T. Loudavaris

⁴Department of Endocrinology and Diabetes, St Vincent’s Hospital and University of Melbourne, Melbourne, Australia
W. J. Hawthorne

⁵National Pancreas Transplant Unit, University of Sydney at Westmead Hospital, Sydney, Australia
P. J. O’Connell

⁵National Pancreas Transplant Unit, University of Sydney at Westmead Hospital, Sydney, Australia
T. Radford

²Central Northern Adelaide Renal and Transplantation Service, and University of Adelaide at Royal Adelaide Hospital, Adelaide, Australia
T. W. H. Kay

⁴Department of Endocrinology and Diabetes, St Vincent’s Hospital and University of Melbourne, Melbourne, Australia
M. Horowitz

¹Endocrine & Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia
P. T. Coates

²Central Northern Adelaide Renal and Transplantation Service, and University of Adelaide at Royal Adelaide Hospital, Adelaide, Australia
D. J. Torpy

¹Endocrine & Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia

Abstract

Islet cell transplantation has emerged as a treatment modality for type 1 diabetes in the last 15 years due to the Edmonton protocol leading to consistent and sustained exogenous insulin independence post-transplantation. In recent years, consortia that involve both local and remote islet cell centers have been established, with local centers responsible for processing and shipping of islet cells, and remote centers only transplanting them. There are, however, few data on patient outcomes at remote centers. A tendency for high fasting glucose despite insulin independence was noted by us and others with an unknown mechanism. This review provides a brief history of islet cell transplantation, and focuses on the South Australian remote center experience: the challenges, screening criteria, and the impact on incretin hormone secretion of insulin independent transplant patients.

Key words

pancreas - islets - transplantation - remote centers - type 1 Diabetes - incretin hormones

Full Text

References

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