Benefits and Risks of Solitary Islet Transplantation for Type 1 Diabetes Using Steroid-Sparing Immunosuppression
Response to Charles and Selam
- Boaz Hirshberg, MD,
- Kristina I. Rother, MD,
- Benigno J. Digon III, MD and
- David M. Harlan, MD
- From the Islet & Autoimmunity Branch, National Institute of Diabetes, Digestive and Kidney Disease (NIDDK), National Institutes of Health (NIH)/Department of Health and Human Services (DHHS), Bethesda, Maryland
- Address correspondence to David M. Harlan, MD, Chief, Islet & Autoimmunity Branch, NIDDK, National Institutes of Health/Department of Health and Human Services, Building 10, Room 8N307, Bethesda, MD 20892. E-mail: davidmh{at}intra.niddk.nih.gov
We thank Drs. Charles and Selam for their thoughtful comments (1) regarding our study describing the National Institutes of Health (NIH) islet transplantation experience (2). We agree that the question remains open whether islet transplantation and subsequent antirejection therapy decrease the morbidity and mortality associated with diabetes. In fact, one of our article’s main messages is the need to develop criteria for identifying patients with “end-stage” diabetes for whom a therapy’s known and unknown risks are most likely to favor an appropriate risk/benefit ratio. We have recently published similar concerns regarding the …
