Clinical protocol for selection of the candidates for islet transplantation

Background: Our intention is to describe the clinical profile of the candidates for islet transplantation in Curitiba, Brazil. Methods: The clinical evaluation was organized in stages: Screening, Initial Evaluation, Evaluation and Waiting List. Candidates' inclusion criteria were hypoglycemia unawareness, glycemic imbalance, chronic progressive diabetic complications, 18-65 years of age and at least 5 years of type 1 diabetes evolution. Results: From September 2003 through September 2006, 92 candidates were clinically evaluated, and 25 fulfilled the Screening criteria, being selected at this stage. The main reason for exclusion was insulin requirement of more than 0.7 IU/kg/ day. At the Initial Evaluation, seven of the 25 patients were excluded as have not agreed to sign the informed consent. Until now, 4 candidates completed the Evaluation stage and two of them are currently enlisted. Conclusions: Candidates for islet transplantation must be rigorously evaluated. Two patients fulfilled all the selection criteria and are currently enlisted.