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Combined Pancreatic Islet and Kidney Transplantation in a Child With Unstable Type 1 Diabetes and End‐Stage Renal Disease
Author(s) -
Benedict K. A.,
Moassesfar S.,
Adi S.,
Gitelman S. E.,
Brennan J. L.,
McEnhill M.,
Stock P. G.,
Portale A. A.,
Posselt A. M.
Publication year - 2013
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.12323
Subject(s) - medicine , transplantation , islet , type 1 diabetes , diabetes mellitus , end stage renal disease , kidney transplantation , hypoglycemia , glycemic , population , kidney , surgery , disease , pediatrics , endocrinology , environmental health
Abstract Islet transplantation after successful kidney transplantation is a recognized treatment for adults with diabetes and end‐stage renal disease (ESRD), but has not been considered an option in the pediatric population. To our knowledge, we report the first combined islet and kidney transplant in a child. The patient was born with bilateral renal hypoplasia and was diagnosed with type 1 diabetes mellitus at age 13 months. He had erratic glycemic control and hypoglycemia unawareness. At 6 years of age, the child safely underwent simultaneous islet and live donor kidney transplantation. Although function of the islet graft was transient, the combined transplant provided significant benefits in terms of glucose control and overall growth and development. Such an approach represents a viable treatment option for pediatric patients with ESRD and unstable diabetes.