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            "title": "Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "A M",
                    "lastName": "Shapiro"
                },
                {
                    "creatorType": "author",
                    "firstName": "J R",
                    "lastName": "Lakey"
                },
                {
                    "creatorType": "author",
                    "firstName": "E A",
                    "lastName": "Ryan"
                },
                {
                    "creatorType": "author",
                    "firstName": "G S",
                    "lastName": "Korbutt"
                },
                {
                    "creatorType": "author",
                    "firstName": "E",
                    "lastName": "Toth"
                },
                {
                    "creatorType": "author",
                    "firstName": "G L",
                    "lastName": "Warnock"
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                {
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                    "firstName": "N M",
                    "lastName": "Kneteman"
                },
                {
                    "creatorType": "author",
                    "firstName": "R V",
                    "lastName": "Rajotte"
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            ],
            "abstractNote": "BACKGROUND: Registry data on patients with type 1 diabetes mellitus who undergo pancreatic islet transplantation indicate that only 8 percent are free of the need for insulin therapy at one year.\nMETHODS: Seven consecutive patients with type 1 diabetes and a history of severe hypoglycemia and metabolic instability underwent islet transplantation in conjunction with a glucocorticoid-free immunosuppressive regimen consisting of sirolimus, tacrolimus, and daclizumab. Islets were isolated by ductal perfusion with cold, purified collagenase, digested and purified in xenoprotein-free medium, and transplanted immediately by means of a percutaneous transhepatic portal embolization.\nRESULTS: All seven patients quickly attained sustained insulin independence after transplantation of a mean (+/-SD) islet mass of 11,547+/-1604 islet equivalents per kilogram of body weight (median follow-up, 11.9 months; range, 4.4 to 14.9). All recipients required islets from two donor pancreases, and one required a third transplant from two donors to achieve sustained insulin independence. The mean glycosylated hemoglobin values were normal after transplantation in all recipients. The mean amplitude of glycemic excursions (a measure of fluctuations in blood glucose concentrations) was significantly decreased after the attainment of insulin independence (from 198+/-32 mg per deciliter [11.1+/-1.8 mmol per liter] before transplantation to 119+/-37 mg per deciliter [6.7+/-2.1 mmol per liter] after the first transplantation and 51+/-30 mg per deciliter [2.8+/-1.7 mmol per liter] after the attainment of insulin independence; P<0.001). There were no further episodes of hypoglycemic coma. Complications were minor, and there were no significant increases in lipid concentrations during follow-up.\nCONCLUSIONS: Our observations in patients with type 1 diabetes indicate that islet transplantation can result in insulin independence with excellent metabolic control when glucocorticoid-free immunosuppression is combined with the infusion of an adequate islet mass.",
            "publicationTitle": "The New England journal of medicine",
            "publisher": "",
            "place": "",
            "date": "Jul 27, 2000",
            "volume": "343",
            "issue": "4",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "230-238",
            "series": "",
            "seriesTitle": "",
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            "journalAbbreviation": "N. Engl. J. Med.",
            "DOI": "10.1056/NEJM200007273430401",
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            "extra": "PMID: 10911004",
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                    "type": 1
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                    "tag": "Antibodies, Monoclonal",
                    "type": 1
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                {
                    "tag": "Antibodies, Monoclonal, Humanized",
                    "type": 1
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                {
                    "tag": "Blood Glucose",
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                    "lastName": "Barton"
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                    "firstName": "Bashoo",
                    "lastName": "Naziruddin"
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                    "firstName": "Jose",
                    "lastName": "Oberholzer"
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                    "firstName": "Peter G",
                    "lastName": "Stock"
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                    "creatorType": "author",
                    "firstName": "Dixon B",
                    "lastName": "Kaufman"
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                    "creatorType": "author",
                    "firstName": "Xunrong",
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                    "lastName": "Cagliero"
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                    "lastName": "Turgeon"
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                    "firstName": "Piotr",
                    "lastName": "Witkowski"
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                    "creatorType": "author",
                    "firstName": "Ali",
                    "lastName": "Naji"
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                    "creatorType": "author",
                    "firstName": "Philip J",
                    "lastName": "O'Connell"
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                    "creatorType": "author",
                    "firstName": "Carla",
                    "lastName": "Greenbaum"
                },
                {
                    "creatorType": "author",
                    "firstName": "Yogish C",
                    "lastName": "Kudva"
                },
                {
                    "creatorType": "author",
                    "firstName": "Kenneth L",
                    "lastName": "Brayman"
                },
                {
                    "creatorType": "author",
                    "firstName": "Meredith J",
                    "lastName": "Aull"
                },
                {
                    "creatorType": "author",
                    "firstName": "Christian",
                    "lastName": "Larsen"
                },
                {
                    "creatorType": "author",
                    "firstName": "Tom W H",
                    "lastName": "Kay"
                },
                {
                    "creatorType": "author",
                    "firstName": "Luis A",
                    "lastName": "Fernandez"
                },
                {
                    "creatorType": "author",
                    "firstName": "Marie-Christine",
                    "lastName": "Vantyghem"
                },
                {
                    "creatorType": "author",
                    "firstName": "Melena",
                    "lastName": "Bellin"
                },
                {
                    "creatorType": "author",
                    "firstName": "A M James",
                    "lastName": "Shapiro"
                }
            ],
            "abstractNote": "OBJECTIVE: To describe trends of primary efficacy and safety outcomes of islet transplantation in type 1 diabetes recipients with severe hypoglycemia from the Collaborative Islet Transplant Registry (CITR) from 1999 to 2010.\nRESEARCH DESIGN AND METHODS: A total of 677 islet transplant-alone or islet-after-kidney recipients with type 1 diabetes in the CITR were analyzed for five primary efficacy outcomes and overall safety to identify any differences by early (1999-2002), mid (2003-2006), or recent (2007-2010) transplant era based on annual follow-up to 5 years.\nRESULTS: Insulin independence at 3 years after transplant improved from 27% in the early era (1999-2002, n = 214) to 37% in the mid (2003-2006, n = 255) and to 44% in the most recent era (2007-2010, n = 208; P = 0.006 for years-by-era; P = 0.01 for era alone). C-peptide ≥0.3 ng/mL, indicative of islet graft function, was retained longer in the most recent era (P < 0.001). Reduction of HbA(1c) and resolution of severe hypoglycemia exhibited enduring long-term effects. Fasting blood glucose stabilization also showed improvements in the most recent era. There were also modest reductions in the occurrence of adverse events. The islet reinfusion rate was lower: 48% by 1 year in 2007-2010 vs. 60-65% in 1999-2006 (P < 0.01). Recipients that ever achieved insulin-independence experienced longer duration of islet graft function (P < 0.001).\nCONCLUSIONS: The CITR shows improvement in primary efficacy and safety outcomes of islet transplantation in recipients who received transplants in 2007-2010 compared with those in 1999-2006, with fewer islet infusions and adverse events per recipient.",
            "publicationTitle": "Diabetes care",
            "publisher": "",
            "place": "",
            "date": "Jul 2012",
            "volume": "35",
            "issue": "7",
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            "partNumber": "",
            "partTitle": "",
            "pages": "1436-1445",
            "series": "",
            "seriesTitle": "",
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            "DOI": "10.2337/dc12-0063",
            "citationKey": "",
            "url": "",
            "accessDate": "",
            "PMID": "",
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            "ISSN": "1935-5548",
            "archive": "",
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