[Pancreatic islets transplantation in the treatment of diabetes mellitus: present and future].
Diabetes treatment with insulin does no prevent the development of secondary complications. For this reason, treatments other than conventional ones are needed, which could bring about an <<almost physiological>> metabolic regulation. This can only be done by transplanting insulin producing tissue, such as vascularised pancreas transplantation, which is an already consolidated clinical procedure these days, or by islets transplantation, which is still a procedure in the clinical research phase. This has the same metabolic objectives as the vascularised transplant, but without the risks of major abdominal surgery, since the islets are implanted in the liver with minimal surgery or using interventionist radiology by means of a catheter. A clinical trial (Edmonton Protocol) was published in the year 2000, which improved the results after islet transplantation by obtaining normoglycaemia periods of more than one year in a consecutive patient series with type 1 diabetes and without using corticoids. This protocol has been endorsed in other centre in different trials. Although the initial results were good, the progress of these patients has shown that many islets transplantations do not manage to maintain insulin-independence indefinitely.
Casanova
Daniel
D
Servicio de Cirugía General y Digestiva, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, España. danielcasanova@telefonica.net
D003920:Diabetes Mellitus / Q000601:surgery*; D005544:Forecasting; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000639:trends