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Correspondence
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Volume 355:1397-1399 September 28, 2006 Number 13
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Autoimmunity after Islet-Cell Allotransplantation

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To the Editor: A 52-year-old man with a 36-year history of type 1 diabetes mellitus complicated by hypoglycemia unawareness received two intrahepatic islet-cell allografts. The glycated hemoglobin value before transplantation was 9.3%. He received 400,000 islet equivalents in the first transplantation and 512,000 in the second transplantation, 5 months later. Grafts were prepared at the Joslin Diabetes Center in Boston. His immunosuppression regimen conformed to the Edmonton protocol.1

Three weeks after the second graft, exogenous insulin was discontinued. The stimulated C-peptide concentration was 2.89 ng per milliliter. The patient did not receive exogenous insulin for 3 months, but thereafter insulin . . . [Full Text of this Article]


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