Pancreatic islet transplantation, what has been achieved since Edmonton break-through.
It has been 6 years since the Edmonton group published their outstanding results with pancreatic islet transplantation patients, demonstrating one-year insulin independence of 100% with type I diabetics. In order to assess what has been achieved for past six years we analyzed the actual state of islet transplantation, based on the updated summary of results from Edmonton and compare this experience with combined results from 19 institutions in North America as reported to the Collaborative Islet Transplant Registry (CITR). CITR data have largely substantiated the reproducibility of the Edmonton procedure. Complete insulin-independence was achieved in more then 55% of patients 1 year after transplant, but this state has not been sustained permanently. Although only 10% of patients remained insulin-free after 5 years, more then 80% of them had still detectable levels of C peptide and substantially improved glycemic control without episodes of hypoglycemia. Even though currently, the islet graft is still not a remedy for every brittle diabetic, islet transplantation has already obtained "nonresearch" status in Canada and is close to having a biological license status approved by the FDA in the United States that would further stimulate progress in the field.
Witkowski
Piotr
P
Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. pw2004@columbia.edu
Zakai
Shama Bader
SB
Rana
Abbas
A
Sledzinski
Zbigniew
Z
Hardy
Mark A
MA
D002096:C-Peptide / Q000097:blood; D002170:Canada; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data / Q000639:trends*; D009656:North America; D012042:Registries / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D013997:Time Factors
D002096:C-Peptide