Advances in pancreatic islet transplantation in humans.
With recent advances in methods of islet isolation and the introduction of more potent and less diabetogenic immunosuppressive therapies, islet transplantation has progressed from research to clinical reality. Presently, several international centres have demonstrated successful clinical outcomes with high rates of insulin independence after islet transplantation. Ongoing refinements in donor pancreas procurement and processing, developments in islet isolation and purification technology, and advances in novel immunological conditioning and induction therapies have led to the acceptance of islet transplantation as a safe and effective therapy for patients with type 1 diabetes. This review provides a historical perspective of islet transplantation, outlines the recent advances and current clinical outcomes, and addresses the present challenges and future directions in clinical islet transplantation.
Nanji
Sulaiman A
SA
Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Shapiro
A M James
AM
D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000276:immunology / Q000601:surgery*; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D007165:Immunosuppression Therapy / Q000379:methods; D007328:Insulin / Q000378:metabolism; D016381:Islets of Langerhans Transplantation / Q000379:methods* / Q000639:trends; D011183:Postoperative Complications; D014019:Tissue Donors; D009927:Tissue and Organ Procurement
D007328:Insulin