Pancreatic islet cell transplantation: update and new developments.
Pancreatic islet cell transplantation is a treatment alternative for patients with type 1 diabetes who experience hypoglycemic unawareness despite maximal care. The good results obtained by the group from Edmonton and other centers, with 80% insulin independence at 1 year posttransplant, are not sustainable over time, with 5-year insulin independence achieved in only 10% of patients. However, persistent graft function, even without insulin independence, results in improved glucose control and avoidance of hypoglycemic events. Changes in organ preservation, islet processing technique, and immunosuppression regimens can result in improvement of results in the future. Islet autotransplantation is an option for patients who undergo total pancreatectomy for chronic pancreatitis with debilitating pain, in which reinfusion of the islets from the resected pancreas can result in avoidance of postsurgical diabetes or enhanced glucose control.
Onaca
Nicholas
N
Transplant Services, Baylor Regional Transplant Institute, Baylor University Medical Center, Dallas, TX 75246, USA. nicholao@baylorhealth.edu
Naziruddin
Bashoo
B
Matsumoto
Shinichi
S
Noguchi
Hirofumi
H
Klintmalm
Goran B
GB
Levy
Marlon F
MF
D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery* / Q000628:therapy; D006085:Graft Survival; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000379:methods; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000379:methods*; D012307:Risk Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D009927:Tissue and Organ Procurement / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D001786:Blood Glucose; D007328:Insulin