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Original Research

Autologous Pancreatic Islet Transplantation in Human Bone Marrow

  1. Paola Maffi1,2,
  2. Gianpaolo Balzano3,
  3. Maurilio Ponzoni4,
  4. Rita Nano2,5,
  5. Valeria Sordi2,5,
  6. Raffaella Melzi2,5,
  7. Alessia Mercalli2,5,
  8. Marina Scavini6,
  9. Antonio Esposito7,
  10. Jacopo Peccatori8,
  11. Elisa Cantarelli2,5,
  12. Carlo Messina8,
  13. Massimo Bernardi8,
  14. Alessandro Del Maschio7,9,
  15. Carlo Staudacher3,9,
  16. Claudio Doglioni4,9,
  17. Fabio Ciceri8,
  18. Antonio Secchi9,10⇑ and
  19. 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.

Diabetes 2013 Oct; 62(10): 3523-3531. https://doi.org/10.2337/db13-0465
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This article has a correction. Please see:

  • Autologous pancreatic islet transplantation in human bone marrow. Diabetes 2013;62:3523–3531 - January 01, 2014

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

  • This article contains Supplementary Data online at http://diabetes.diabetesjournals.org/lookup/suppl/doi:10.2337/db13-0465/-/DC1.

  • See accompanying commentary, p. 3333.

  • Received March 25, 2013.
  • Accepted May 23, 2013.
  • © 2013 by the American Diabetes Association.

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.

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Autologous Pancreatic Islet Transplantation in Human Bone Marrow
Paola Maffi, Gianpaolo Balzano, Maurilio Ponzoni, Rita Nano, Valeria Sordi, Raffaella Melzi, Alessia Mercalli, Marina Scavini, Antonio Esposito, Jacopo Peccatori, Elisa Cantarelli, Carlo Messina, Massimo Bernardi, Alessandro Del Maschio, Carlo Staudacher, Claudio Doglioni, Fabio Ciceri, Antonio Secchi, Lorenzo Piemonti
Diabetes Oct 2013, 62 (10) 3523-3531; DOI: 10.2337/db13-0465

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Autologous Pancreatic Islet Transplantation in Human Bone Marrow
Paola Maffi, Gianpaolo Balzano, Maurilio Ponzoni, Rita Nano, Valeria Sordi, Raffaella Melzi, Alessia Mercalli, Marina Scavini, Antonio Esposito, Jacopo Peccatori, Elisa Cantarelli, Carlo Messina, Massimo Bernardi, Alessandro Del Maschio, Carlo Staudacher, Claudio Doglioni, Fabio Ciceri, Antonio Secchi, Lorenzo Piemonti
Diabetes Oct 2013, 62 (10) 3523-3531; DOI: 10.2337/db13-0465
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