Islet Cell Transplantation Alone and CD34+ Enriched Bone Marrow Cell Infusion in Patients With Diabetes Mellitus: Steroid-Free Regimen

This study has been completed.
Sponsor:
Information provided by:
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
ClinicalTrials.gov Identifier:
NCT00021801
First received: August 4, 2001
Last updated: March 1, 2010
Last verified: March 2010
  Purpose

The goal of islet cell transplantation in Type 1 diabetics is to provide those affected with constant normal blood glucose levels, thereby reducing or eliminating altogether the need for injected insulin. This normalization may prevent or slow progression of diabetic complications, result in a healthier lifestyle, and lead to a better quality of life.

Participants who meet the inclusion criteria will undergo an extensive screening process which typically includes a series of blood tests, EKG, chest x-rays, and a psychological evaluation, among others. Those who are eligible for and chose to participate in the trial will receive an islet cell transplant and bone marrow infusion from the same donor, together with following immunosuppressive medications: tacrolimus, sirolimus, daclizumab and infliximab. Because the bone marrow infusion may successfully prevent the transplanted islet cells from rejecting, some participants may be able to stop taking the immunosuppressive medications after a year.

The islet cell transplant is done under local anesthesia in a special procedure radiology room. Several days after the islet cell transplant, the participant is admitted to the hospital as an outpatient in order to receive bone marrow via a simple intra-venous infusion procedure.

All participants will need to be seen at the Diabetes Research Institute after the transplant for follow-up testing and post-islet cell transplant care.


Condition Intervention Phase
Type 1 Diabetes Mellitus
Procedure: Islet Cell Transplantation
Phase 2

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: Pathways to Tolerance in Human Islet Transplantation

Resource links provided by NLM:


Further study details as provided by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

Study Start Date: March 2000
Estimated Study Completion Date: September 2000
  Eligibility

Ages Eligible for Study:   18 Years to 50 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Candidates must be between the ages of 18 and 50.
  • Candidates must have had insulin-dependent diabetes mellitus (IDDM) for at least 5 years and been under physician care for at least 6 months prior to enrollment in trial.
  • Eligible candidates will have poorly controlled IDDM and manifest signs and symptoms severe enough to be incapacitating. These symptoms can include episodes of hypoglycemic unawareness (failure to recognize blood glucose levels < 54 mg/dl) or episodes requiring the assistance of others.
  • Candidates may have poor diabetes control despite intensive insulin therapy (HbA1c > 8.0%).
  • Creatinine clearance should be > 60 ml/min)
  • Body Mass Index should be less than 26
  • Women of child-bearing age must have a negative pregnancy test and agree to follow effective contraceptive measures for the duration of the trial.

Exclusion Criteria:

  • Previous or concurrent organ transplant
  • Previous or concurrent malignancy
  • Untreated proliferative diabetic retinopathy
  • Unstable cardiovascular status, including positive stress echocardiography (if > age 35)
  • Active infections, including x-ray evidence of pulmonary infection
  • Peptic ulcer disease, gall stones, or portal hypertension
  • Abnormal liver function tests
  • Presence of panel reactive antibodies > 20%
  • Creatinine clearance < 60 ml/min
  • HbA1c > 12%
  • Serological evidence of HIV, HbsAg, or HCV
  • Anemia (hemoglobin < 12.0)
  • Any condition or circumstance, including psychogenic factors, that preclude therapeutic compliance or otherwise make it unsafe to undergo an islet cell transplant.
  • PSA > 4 in males
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00021801

Locations
United States, Florida
University of Miami Diabetes Research Institute
Miami, Florida, United States, 33136
Sponsors and Collaborators
Investigators
Principal Investigator: Rodolfo Alejandro, MD University of Miami Diabetes Research Institute
  More Information

Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
ClinicalTrials.gov Identifier: NCT00021801     History of Changes
Other Study ID Numbers: dk56953 (completed), DK56953-01
Study First Received: August 4, 2001
Last Updated: March 1, 2010
Health Authority: United States: Federal Government

Keywords provided by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):
Type I Diabetes Mellitus
Immunosuppression
Islet Cell Transplant
Percutaneous Transhepatic Portal

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 1
Autoimmune Diseases
Endocrine System Diseases
Glucose Metabolism Disorders
Immune System Diseases
Metabolic Diseases

ClinicalTrials.gov processed this record on October 23, 2014