The start of an islet transplantation program in Japan

T. Saito, K. Ise, Y. Sato, M. Gotoh, S. Matsumoto, Takashi Kenmochi, Y. Kuroda, Y. Yasunami, K. Inoue, S. Teraoka

Research output: Contribution to journalArticle

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Abstract

In Japan, pancreas donation had become possible from cadaveric donor sources, both heart-beating or non-heart-beating (NHB). Pancreas allografts have been distributed in the organ allocation system of the Japan Organ Transplant Network. Meanwhile, islet transplantation has been categorized as a tissue transplantation; it is free from legal restraints. Thus, pancreata for islet isolation must be obtained from NHB donors. Herein we report the starting program and preliminary results of islet transplantation in Japan. Selection and listing criteria for transplantation include regional priority, ABO blood type, previous islet transplant status with insulin independence, and a longer waiting time. Five institutes in Japan (Fukushima, Chiba, Kyoto, Kobe, and Fukuoka) are prepared to start programs. A two-layer cold storage method using perfluorocarbons and UW solution is recommended for pancreas preservation. Islet isolation and purification procedures are performed according to institute-specific protocol. Immunosuppression is based on sirolimus/tacrolimus combined with basiliximab induction. Two or three consecutive infusions of >5000 IE/kg are planned for each recipient until achieving insulin independence. Twenty-seven isolations and 14 transplants were performed in eight non-insulin-dependent diabetes mellitus (IDDM) recipients. Almost all (26 of 27) were NHB donors. All recipients are free from hypoglycemic episode after transplantation. One of these recipients is insulin independent; the others are currently on minimal doses of exogenous insulin. The feasibility of islet transplantation using NHB donors was confirmed using a two-layer cold storage method and a steroid-free immunosuppressive protocol, with a high rate of graft function.

Original languageEnglish
Pages (from-to)3424-3426
Number of pages3
JournalTransplantation Proceedings
Volume37
Issue number8
DOIs
Publication statusPublished - 01-10-2005

Fingerprint

Islets of Langerhans Transplantation
Pancreas
Japan
Insulin
Transplants
Transplantation
Fluorocarbons
Tissue Transplantation
Tacrolimus
Sirolimus
Immunosuppressive Agents
Hypoglycemic Agents
Immunosuppression
Type 2 Diabetes Mellitus
Patient Selection
Allografts
Steroids

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

Saito, T., Ise, K., Sato, Y., Gotoh, M., Matsumoto, S., Kenmochi, T., ... Teraoka, S. (2005). The start of an islet transplantation program in Japan. Transplantation Proceedings, 37(8), 3424-3426. https://doi.org/10.1016/j.transproceed.2005.09.039
Saito, T. ; Ise, K. ; Sato, Y. ; Gotoh, M. ; Matsumoto, S. ; Kenmochi, Takashi ; Kuroda, Y. ; Yasunami, Y. ; Inoue, K. ; Teraoka, S. / The start of an islet transplantation program in Japan. In: Transplantation Proceedings. 2005 ; Vol. 37, No. 8. pp. 3424-3426.
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abstract = "In Japan, pancreas donation had become possible from cadaveric donor sources, both heart-beating or non-heart-beating (NHB). Pancreas allografts have been distributed in the organ allocation system of the Japan Organ Transplant Network. Meanwhile, islet transplantation has been categorized as a tissue transplantation; it is free from legal restraints. Thus, pancreata for islet isolation must be obtained from NHB donors. Herein we report the starting program and preliminary results of islet transplantation in Japan. Selection and listing criteria for transplantation include regional priority, ABO blood type, previous islet transplant status with insulin independence, and a longer waiting time. Five institutes in Japan (Fukushima, Chiba, Kyoto, Kobe, and Fukuoka) are prepared to start programs. A two-layer cold storage method using perfluorocarbons and UW solution is recommended for pancreas preservation. Islet isolation and purification procedures are performed according to institute-specific protocol. Immunosuppression is based on sirolimus/tacrolimus combined with basiliximab induction. Two or three consecutive infusions of >5000 IE/kg are planned for each recipient until achieving insulin independence. Twenty-seven isolations and 14 transplants were performed in eight non-insulin-dependent diabetes mellitus (IDDM) recipients. Almost all (26 of 27) were NHB donors. All recipients are free from hypoglycemic episode after transplantation. One of these recipients is insulin independent; the others are currently on minimal doses of exogenous insulin. The feasibility of islet transplantation using NHB donors was confirmed using a two-layer cold storage method and a steroid-free immunosuppressive protocol, with a high rate of graft function.",
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Saito, T, Ise, K, Sato, Y, Gotoh, M, Matsumoto, S, Kenmochi, T, Kuroda, Y, Yasunami, Y, Inoue, K & Teraoka, S 2005, 'The start of an islet transplantation program in Japan', Transplantation Proceedings, vol. 37, no. 8, pp. 3424-3426. https://doi.org/10.1016/j.transproceed.2005.09.039

The start of an islet transplantation program in Japan. / Saito, T.; Ise, K.; Sato, Y.; Gotoh, M.; Matsumoto, S.; Kenmochi, Takashi; Kuroda, Y.; Yasunami, Y.; Inoue, K.; Teraoka, S.

In: Transplantation Proceedings, Vol. 37, No. 8, 01.10.2005, p. 3424-3426.

Research output: Contribution to journalArticle

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AU - Saito, T.

AU - Ise, K.

AU - Sato, Y.

AU - Gotoh, M.

AU - Matsumoto, S.

AU - Kenmochi, Takashi

AU - Kuroda, Y.

AU - Yasunami, Y.

AU - Inoue, K.

AU - Teraoka, S.

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N2 - In Japan, pancreas donation had become possible from cadaveric donor sources, both heart-beating or non-heart-beating (NHB). Pancreas allografts have been distributed in the organ allocation system of the Japan Organ Transplant Network. Meanwhile, islet transplantation has been categorized as a tissue transplantation; it is free from legal restraints. Thus, pancreata for islet isolation must be obtained from NHB donors. Herein we report the starting program and preliminary results of islet transplantation in Japan. Selection and listing criteria for transplantation include regional priority, ABO blood type, previous islet transplant status with insulin independence, and a longer waiting time. Five institutes in Japan (Fukushima, Chiba, Kyoto, Kobe, and Fukuoka) are prepared to start programs. A two-layer cold storage method using perfluorocarbons and UW solution is recommended for pancreas preservation. Islet isolation and purification procedures are performed according to institute-specific protocol. Immunosuppression is based on sirolimus/tacrolimus combined with basiliximab induction. Two or three consecutive infusions of >5000 IE/kg are planned for each recipient until achieving insulin independence. Twenty-seven isolations and 14 transplants were performed in eight non-insulin-dependent diabetes mellitus (IDDM) recipients. Almost all (26 of 27) were NHB donors. All recipients are free from hypoglycemic episode after transplantation. One of these recipients is insulin independent; the others are currently on minimal doses of exogenous insulin. The feasibility of islet transplantation using NHB donors was confirmed using a two-layer cold storage method and a steroid-free immunosuppressive protocol, with a high rate of graft function.

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