Pancreatic and islet transplantation.
Diabetes mellitus is the most devastating chronic disease of all time. This review discusses the current therapies for type 1 diabetes that are predicated on the restoration of insulin secretion by transplantation. Recent developments in vascularized pancreas transplantation have led to a dramatic increase in the number of these procedures performed worldwide, with over 10,000 cases reported currently to the International Pancreas Transplant Registry. Although the procedure contributes to a significant improvement in quality of life, compared with traditional insulin therapy, it still suffers from a number of shortcomings, including a persistently high postoperative morbidity rate and the requirement of long-term immunosuppression. Islet transplantation is therefore being pursued actively as an equally efficient means of restoring normoglycemia, but without the attendant morbidity of the whole-organ procedure, and hopefully with a significantly reduced need for immunosuppression.
Rosenberg
L
L
Departments of Surgery and Medicine, McGill University, and The Centre for Pancreatic Diseases, McGill University Health Centre, Montreal General Hospital, 1650 Cedar Avenue, L9-424, Montreal, Quebec H3G 1A4, Canada. cxlw@musica.mcgill.ca
D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy; D016381:Islets of Langerhans Transplantation; D016035:Pancreas Transplantation / Q000379:methods; D011183:Postoperative Complications; D011788:Quality of Life
D001786:Blood Glucose