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September 28, 2005

Single-Donor Islet Transplantation for Diabetes

JAMA. 2005;294(12):1488-1489. doi:10.1001/jama.294.12.1488-a

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.