Improving efficacy of clinical islet transplantation with @entity7568 -based islet purification, thymoglobulin induction, and blockage of @entity1356 and XXXX .

@entity1 @entity32 @entity7568 @entity6 @entity1356 @entity310 @entity3446 @entity1140 @entity6051
Poor efficacy is one of the issues for clinical islet transplantation. Recently, we demonstrated that pancreatic ductal preservation significantly improved the success rate of islet isolation; however, two transplants were necessary to achieve insulin independence. In this study, we introduced @entity7568 -based purification, thymoglobulin induction, and double blockage of @entity1356 and @entity310 as well as @entity3446 -free immunosuppression to improve the efficacy of clinical islet transplantation. Nine clinical-grade @entity1 pancreata were procured. Pancreatic ductal preservation was performed using ET-Kyoto solution in all cases. When the isolated islets met the clinical criteria, they were transplanted. We utilized two methods of immunosuppression and anti- @entity32 . The first protocol prescribed daclizumab for induction, then @entity3446 and @entity1140 to maintain immunosuppression. The second protocol used thymoglobulin for induction and @entity1140 and @entity6051 mofetil to maintain immunosuppression. Eternacept and anakinra were administered as anti-inflammatory drugs. The total amount of insulin required, HbA1c, and the SUITO index were determined to analyze and compare the results of transplantation. All isolated islet preparations (9/9) met the criteria for clinical transplantation, and they were transplanted into six type 1 @entity6 @entity1 . All @entity1 achieved insulin independence with normal HbA1c levels; however, the first protocol required two islet infusions (N = 3) and the second protocol only required a single infusion (N = 3). The average SUITO index, at 1 month after a single-donor islet transplantation, was significantly higher in the second protocol (49.6    8.3 vs. 19.3    6.3, p < 0.05). Pancreatic ductal preservation, @entity7568 -based purification combined with thymoglobulin induction, and blockage of @entity1356 and @entity310 as well as @entity3446 -free immunosuppression dramatically improved the efficacy of clinical islet transplantations. This protocol enabled us to perform successful single-donor islet transplantations. Further large-scale studies are necessary to confirm these results and clarify the mechanism of each component.
