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Diabetes Research Group. Clinical islet transplantation. Stephanie A Amiel, BSc, MD, FRCP RD Lawrence Professor of Diabetic Medicine King’s College London School of Medicine. INSU U100. Treatment of organ failure?. Renal failure Liver failure Heart failure Islet failure.

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clinical islet transplantation

Diabetes

Research

Group

Clinical islet transplantation

Stephanie A Amiel, BSc, MD, FRCP

RD Lawrence Professor of Diabetic Medicine

King’s College London School of Medicine

treatment of organ failure

INSU

U100

Treatment of organ failure?
  • Renal failure
  • Liver failure
  • Heart failure
  • Islet failure
  • Kidney transplant
  • Liver transplant
  • Heart transplant
case histories
Case Histories
  • Born 1944; T1DM 1966; keen runner
  • Born 1965; T1DM 1987; HCA on locked ward
  • Born 1985; T1DM 1994; mother of two

“afraid to be in charge of my granddaughter”

“threatened with medical redundancy”

“you just drove across a red light, Mummy”

islet transplantation
Islet Transplantation
  • 1998 established laboratory
  • 2000 proof of concept
  • 2002 1st UK patient
  • 2008 NCG funded programme
insulin independence insulin dependence graft failure

CITR Islet Alone Recipients outcome

From all infusions

Insulin Independence, Insulin Dependence, Graft failure

*C-peptide data not available at Day 75

**Year 3 status independent of re-infusion

slide9

Clinical Outcomes: Diabetes UK patients

  • 3 people achieved insulin independence
  • 1 person with 4% reduction in HbA1c
  • 2 people back in work
  • 1 woman resumed running and babysitting her grandchildren
  • 2 children safely back on school run
slide10

UK ITC

NCG:

April 2008

2 isolation centres

6 Transplant centres

Intractable hypoglycaemia

Islet after kidney

Local and remote

Shaw, Manus, Amiel, Huang

problems to be solved
Problems to be solved
  • Current
      • Organ supply/distribution
      • Sub-optimal immunosuppression
  • Research
      • Prevent loss of islets on administration
      • Improve immunosuppression
      • Make new islets to give greater loads and re-transplant if required
meanwhile
Meanwhile
  • Whatever cell therapy we devise, it will need to be safer than insulin therapy
  • For a small number of patients, it already is