To the Editor: Dr Hering and colleagues1 describe their experience with single-donor marginal-dose
islet transplantation in patients with type 1 diabetes. I believe that there
are flaws in their premises and that the results are subject to a different
interpretation. It is not clear that restoration of insulin independence must
be achieved with a single donor “for islet transplants to become a widespread
clinical reality.” The authors state that a single-donor transplant
will reduce the risks of transplantation, but the basis of the lowered risk
lies in the single transplant procedure, not the number of donors. Transplanting
islets pooled from multiple donors in a single transplant procedure entails
minimal, if any, added risk compared with a single-donor transplant.
Smith CV. Single-Donor Islet Transplantation for Diabetes. JAMA. 2005;294(12):1488–1489. doi:10.1001/jama.294.12.1488-a
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