Autologous Pancreatic Islet Transplantation in Human Bone Marrow

  1. Lorenzo Piemonti2,5
  1. 1Islet Transplantation Unit, Diabetes Research Institute, Ospedale San Raffaele, Milan, Italy
  2. 2Division of Immunology, Transplantation, and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
  3. 3Department of Surgery, San Raffaele Scientific Institute, Milan, Italy
  4. 4Department of Pathology, San Raffaele Scientific Institute, Milan, Italy
  5. 5Beta Cell Biology Unit, Diabetes Research Institute, Ospedale San Raffaele, Milan, Italy
  6. 6Epidemiology and Data Management Unit, Diabetes Research Institute, Ospedale San Raffaele, Milan, Italy
  7. 7Department of Radiology, San Raffaele Scientific Institute, Milan, Italy
  8. 8Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
  9. 9Vita-Salute San Raffaele University, Milan, Italy
  10. 10Clinical Transplant Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy.
  1. Corresponding author: Lorenzo Piemonti, piemonti.lorenzo{at}hsr.it, or Antonio Secchi, secchi.antonio{at}hsr.it.
  1. P.M. and G.B. contributed equally to this work.

Abstract

The liver is the current site of choice for pancreatic islet transplantation, even though it is far from being ideal. We recently have shown in mice that the bone marrow (BM) may be a valid alternative to the liver, and here we report a pilot study to test feasibility and safety of BM as a site for islet transplantation in humans. Four patients who developed diabetes after total pancreatectomy were candidates for the autologous transplantation of pancreatic islet. Because the patients had contraindications for intraportal infusion, islets were infused in the BM. In all recipients, islets engrafted successfully as shown by measurable posttransplantation C-peptide levels and histopathological evidence of insulin-producing cells or molecular markers of endocrine tissue in BM biopsy samples analyzed during follow-up. Thus far, we have recorded no adverse events related to the infusion procedure or the presence of islets in the BM. Islet function was sustained for the maximum follow-up of 944 days. The encouraging results of this pilot study provide new perspectives in identifying alternative sites for islet infusion in patients with type 1 diabetes. Moreover, this is the first unequivocal example of successful engraftment of endocrine tissue in the BM in humans.

Footnotes

  • Received March 25, 2013.
  • Accepted May 23, 2013.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

| Table of Contents

This Article

  1. Diabetes vol. 62 no. 10 3523-3531
  1. Supplementary Data
  2. All Versions of this Article:
    1. db13-0465v1
    2. 62/10/3523 most recent