Combined islet-lung transplantation in a cystic fibrosis patient.

Détails

ID Serval
serval:BIB_738E68E41D2D
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Combined islet-lung transplantation in a cystic fibrosis patient.
Périodique
Schweizerische Medizinische Wochenschrift. Supplementum
Auteur(s)
Bühler L., Andereggen E., Deng S., Spiliopoulos A., Nicod L., Rochat T., Tschopp J.M., Cretin N., Fournier B., Conrad B., Mentha G., Morel P.
ISSN
0036-7672
ISSN-L
0250-5525
Statut éditorial
Publié
Date de publication
1996
Volume
79
Pages
73S-75S
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Résumé
The prevalence of insulin-dependent diabetes mellitus (IDDM) in cystic fibrosis patients ranges from 2 to 8% and glucose intolerance up to 15%. In recent years, lung transplantation has helped to prolong life expectancy of cystic fibrosis patients and represents 10 to 30% of all indications for lung transplantation. The postoperative need for immunosuppressive therapy using diabetogenic agents has decompensatory effects on glucose regulation and will probably increase the number of insulin-dependent cystic fibrosis patients. We report the case of an insulin-dependent cystic fibrosis patient transplanted with a combined islet-lung allograft. The pre-transplantation C-peptide level was below 0.04 nmol/l and preoperative insulin requirement was some 100 U per day. A sequential bipulmonary lung transplantation was performed and, using the pancreas of the same donor, we isolated and purified the islets of Langerhans by a modified automated method. We obtained 232,200 islets equivalent, which were injected into the liver by portal embolization. The postoperative course was uncomplicated, the insulin requirement decreased to 50% of the preoperative need and the C-peptide value increased to normal values and remained with the normal range during a follow-up period of 15 months. In conclusion, we believe that, besides type I diabetic patients, insulin-dependent cystic fibrosis patients with a negative C-peptide value could also be good candidates for combined islet-lung allotransplantation.
Mots-clé
Adult, Cystic Fibrosis/complications, Cystic Fibrosis/surgery, Diabetes Mellitus, Type 1/complications, Diabetes Mellitus, Type 1/surgery, Drug Therapy, Combination, Humans, Immunosuppressive Agents/administration & dosage, Islets of Langerhans Transplantation/methods, Lung Transplantation/methods, Male
Pubmed
Web of science
Création de la notice
09/09/2011 20:20
Dernière modification de la notice
03/03/2018 18:19
Données d'usage