Balloon-occluded retrograde transvenous obliteration is a feasible alternative to a transjugular intrahepatic portosystemic shunt for patients with large gastrorenal shunts or hepatic encephalopathy (or both).
BackgroundAllogeneic islet transplantation has become a viable option for the treatment of unstable type 1 diabetes. However, the donor shortage and the necessity of the immunosuppressive drugs are two major issues. To solve these issues, we performed islet xenotransplantation using encapsulated neonatal porcine islets without immunosuppressive drugs.MethodsTwo different doses (approximately 5000 IEQ/kg and 10,000 IEQ/kg) of encapsulated neonatal porcine islets were transplanted twice (total approximately 10,000 IEQ/kg and 20,000 IEQ/kg) into four type 1 diabetic patients in each group (total 8 patients).FindingsIn the higher dose group, all four patients improved HbA1c. This was maintained at a level of < 7% for > 600 days with significant reduction of the frequency of unaware hypoglycemic events.InterpretationThe clinical benefit of islet xenotransplantation with microencapsulation has been shown.
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