Presentation is loading. Please wait.

Presentation is loading. Please wait.

Clinical islet transplantation Stephanie A Amiel, BSc, MD, FRCP RD Lawrence Professor of Diabetic Medicine Kings College London School of Medicine Diabetes.

Similar presentations


Presentation on theme: "Clinical islet transplantation Stephanie A Amiel, BSc, MD, FRCP RD Lawrence Professor of Diabetic Medicine Kings College London School of Medicine Diabetes."— Presentation transcript:

1 Clinical islet transplantation Stephanie A Amiel, BSc, MD, FRCP RD Lawrence Professor of Diabetic Medicine Kings College London School of Medicine Diabetes Research Group

2 Treatment of organ failure? Renal failure Liver failure Heart failure Islet failure Kidney transplant Liver transplant Heart transplant INSU U100

3 Case Histories 1.Born 1944; T1DM 1966; keen runner 2.Born 1965; T1DM 1987; HCA on locked ward 3.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

4 GLUCOSE-RESPONSIVE INSULIN DELIVERY Bionics vs nature?

5 Nature – whole pancreas or islets?

6 Islet Transplantation 1998 established laboratory 2000 proof of concept st UK patient 2008 NCG funded programme

7 Insulin Independence, Insulin Dependence, Graft failure *C-peptide data not available at Day 75 **Year 3 status independent of re-infusion CITR Islet Alone Recipients outcome From all infusions

8 CITR 2007 SEVERE HYPOGLYCEMIA FOLLOWING LAST TRANSPLANT

9 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 3 people achieved insulin independence Clinical Outcomes: Diabetes UK patients

10 UK ITC Shaw, Manus, Amiel, Huang NCG: April isolation centres 6 Transplant centres Intractable hypoglycaemia Islet after kidney Local and remote

11 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

12 Meanwhile Whatever cell therapy we devise, it will need to be safer than insulin therapy For a small number of patients, it already is


Download ppt "Clinical islet transplantation Stephanie A Amiel, BSc, MD, FRCP RD Lawrence Professor of Diabetic Medicine Kings College London School of Medicine Diabetes."

Similar presentations


Ads by Google