title: Immunological aspects of pancreatic islet cell transplantation.
abstract: Type 1 diabetes mellitus (T1DM) is one of the most common diseases of childhood. Insulin discovery changed the clinical course of T1DM from an acutely fatal disease to a chronic disease, but this discovery was later found to be inefficient to control its long-term complications. Whole-pancreas and islet cell transplantation seem to provide a potential solution by restoring the normal physiology of glucose-insulin homeostasis. Although islet transplantation is less invasive than whole-pancreas transplantation, the insulin-free state after islet transplantation remained low (10%) at 5 years after surgery. Here, we will present the specific immunologic challenges that are specific to islet cell transplantation, including instant blood-mediated inflammatory reaction and the recurrence of autoimmunity. We will also briefly discuss the immunosuppressive regimens used and the recent radiologic techniques in the detection of engraftment and early rejection of islet cells.
authors.affiliation: Transplantation Research Center (TRC), Brigham and Women's Hospital, Harvard Medical School, 227 Longwood Avenue, Boston, MA 02115, USA. jazzi@rics.bwh.harvard.edu
authors.forename: Jamil
authors.initials: J
authors.lastname: Azzi
authors.forename: Abdallah S
authors.initials: AS
authors.lastname: Geara
authors.forename: Suzanne
authors.initials: S
authors.lastname: El-Sayegh
authors.forename: Reza
authors.initials: R
authors.lastname: Abdi
mesh_terms: D000818:Animals; D015551:Autoimmunity / Q000187:drug effects; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000601:surgery*; D006084:Graft Rejection / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007249:Inflammation / Q000276:immunology / Q000517:prevention & control; D018836:Inflammation Mediators / Q000097:blood; D016381:Islets of Langerhans Transplantation / Q000276:immunology*; D013997:Time Factors; D023001:Transplantation Tolerance / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D018836:Inflammation Mediators