Gores P F, Najarian J S, Stephanian E, Lloveras J J, Kelley S L, Sutherland D E
Department of Surgery, University of Minnesota, Minneapolis.
Lancet. 1993 Jan 2;341(8836):19-21. doi: 10.1016/0140-6736(93)92484-b.
Islet transplantation has been slow to develop as a therapy for type I diabetes mellitus. Conventional immunosuppression does not protect islet allografts from early failure and by current techniques the yield of purified islets from a single pancreas is inadequate or only marginally in excess of the number needed to sustain normoglycaemia. We transplanted unpurified islets from a single pancreas concomitantly with a kidney to two uraemic diabetic patients. The novel agent 15-deoxyspergualin, along with antilymphocyte globulin, was used for induction immunosuppression, and azathioprine, prednisone, and cyclosporin for maintenance. Islet function has been sustained in both, and the second patient is insulin-independent and euglycaemic more than 6 months after transplantation.