title: Update on islet transplantation.
abstract: Clinical islet transplantation has progressed considerably over the past 12 years, and >750 patients with type 1 diabetes have received islet transplants internationally over this time. Many countries are beginning to accept the transition from research to accepted and funded clinical care, especially for patients with brittle control that cannot be stabilized by more conventional means. Major challenges remain, including the need for more than one donor, and the requirement for potent, chronic immunosuppression. Combining immunological tolerance both to allo- and autoantigens, and a limitless expandable source of stem cell- or xenograft-derived insulin-secreting cells represent remaining hurdles in moving this effective treatment to a potential cure for all those with type 1 or 2 diabetes.
authors: Clinical Islet Transplant Program and Department of Surgery, University of Alberta, Edmonton, Alberta T6G 2B7, Canada.
authors: Michael
authors: M
authors: McCall
authors: A M James
authors: AM
authors: Shapiro
mesh_terms: D000818:Animals; D017209:Apoptosis; D015551:Autoimmunity; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007165:Immunosuppression Therapy; D007249:Inflammation / Q000517:prevention & control; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods*; D009336:Necrosis; D011168:Portal System; D009927:Tissue and Organ Procurement; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D014409:Tumor Necrosis Factor-alpha