Benefits and Risks of Solitary Islet Transplantation for Type 1 Diabetes Using Steroid-Sparing Immunosuppression
Response to Hirshberg et al.
- M. Arthur Charles, MD, PHD, and
- Jean-Louis Selam, MD
- From the Diabetes Research Center
- Address correspondence to Dr. M. Arthur Charles, Diabetes Research Center, 2492 Walnut Ave., Suite 130, Tustin, CA 92780. E-mail: macharle{at}uci.edu
The report by Hirshberg et al. (1) describes the National Institutes of Health (NIH) experience in islet-only transplantation using the medical indication of severe hypoglycemia. Although the report details islet transplantation, there was little hypoglycemic information. Because of the potential side effects comparing the medical indication and the treatment, we have scientific, educational, and ethical concerns.
The first concern is the relative morbidity and mortality between severe hypoglycemia and islet transplantation. The mortality associated with severe hypoglycemia is unclear, but estimates show that 0–4% of type 1 diabetic patients …
