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.
研究概览
研究类型
注册 (实际的)
阶段
- 阶段2
- 阶段1
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的: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).
|
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
|---|---|
|
hemorrhage
大体时间:1 month
|
1 month
|
次要结果测量
结果测量 |
大体时间 |
|---|---|
|
Infection
大体时间:6 month
|
6 month
|
|
Exogenous insulin requirement
大体时间:1 year
|
1 year
|
|
Glucose
大体时间:1 year
|
1 year
|
|
C-peptide
大体时间:1 year
|
1 year
|
合作者和调查者
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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