Islet Transplantation Through an Indwelling Catheter in the Umbilical Vein
Islet transplantation is one of the effective and promising options for type 1 diabetes mellitus treatment1-4. The liver is the primary target location for infusion and portal vein catheterization is generally used. Percutaneous transjugular, percutaneous transhepatic, laparoscopically transmesenteric and laparoscopically transumbilical approaches were often utilized to access the portal. Current islet infusion approach via portal vein of liver has various defects. Percutaneous trans-hepatic puncture is risk of possible severe hemorrhage and portal thrombosis. The laparoscopic entry techniques require longer surgical duration and have an increased rate of catheterization failure. Moreover, the catheters were not allowed to indwell for subsequent infusions.
In the current study, the investigators aim to performed open surgery, catheterized the umbilical vein and infused islets into the portal vein. The catheter was indwelled for one month after surgery. Therapeutic effects, surgical parameters and complications were observed to evaluate feasibility and safety.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 2
- Fase 1
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Male and female patients age 18 to 60 years of age.
- Ability to provide written informed consent.
- Clinical history compatible with type 1 diabetes (T1DM) as defined by the WHO guidelines(2007) on the Diagnosis and classification of Diabetes Mellitus.
- manifest signs and symptoms that are severe enough to be incapacitating.
- Basal C-peptide<0.5ng/mL
- patients with poor diabetes control (HbA1c >7% but <12%)
- progressive diabetic complications.
Exclusion Criteria:
- age <18 years or >60 years
- diabetic history <5 years
- BMI>27
- body weight >80kg
- exogenous insulin requirement >1 unit/kg/day
- severe anemia (male <8g/dl, female <7g/dl)
- low white blood cell count (<3000/dl)
- liver dysfunction
- Symptomatic peptic ulcer disease
- Any malignancy
- Active infection including hepatitis B, hepatitis C, HIV, or TB
- panel reactive antibody >20%
- Any medical condition that, in the opinion of the investigator, will interfere with the safe completion of the trial.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Umbilical vein
umbilical vein catheterization
|
A 7 cm incision was made in the middle-right of upper abdominal.
The umbilical vein was identified located 4cm beyond umbilicus, which was then half dissected transversely and the atresic venous lumen was recanalized with a common duct probe (3mm-5mm, BAKES).
A breakthrough feeling would be sensed after approaching forward for 10-14cm and the umbilical vein was successfully recanalized.
The common duct probe was pulled out.
A catheter (single lumen central venous catheter, 16-20G, TUOREN, China) was then cannulated for 15cm into left branch of portal vein through umbilical vein.
The procedure was observed with Doppler ultrasound (LOGIQ S6, GE).
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
hemorrhage
Tidsramme: 1 month
|
1 month
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Infection
Tidsramme: 6 month
|
6 month
|
|
Exogenous insulin requirement
Tidsramme: 1 year
|
1 year
|
|
Glucose
Tidsramme: 1 year
|
1 year
|
|
C-peptide
Tidsramme: 1 year
|
1 year
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- Umbilical-vein
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