title: Islet transplantation in type 1 diabetes: hype, hope and reality - a clinician's perspective.
abstract: The β-cell replacement by islet transplantation is an attractive approach for normalizing blood glucose without hypoglycaemia in patient with type 1 diabetes mellitus (T1D). A pioneer study by the Edmonton group more than a decade ago showed that alloislet transplantation may result in insulin independence for at least 1 year after transplantation. This breakthrough excited researchers, physicians and patients, who felt that the ultimate goal of cure for T1D was at hand. Longer follow-up of patients who underwent islet transplantation showed less favourable results, with only approximately 10% of the patients remaining insulin-free 5 years after transplantation. In the last few years, progress has been made, and the success rate of islet transplantation has steadily increased. Important hurdles, however, related to limited tissue supply and need for life-long immunosuppressive drugs have yet to be overcome. Herein, we review recent achievements in islet transplantation and the challenges that still need to be addressed before this procedure can become a standard therapy for T1D.
authors.affiliation: Endocrinology and Metabolism Service, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Adar
authors.initials: A
authors.lastname: Zinger
authors.forename: Gil
authors.initials: G
authors.lastname: Leibowitz
mesh_terms: D000818:Animals; D003226:Congresses as Topic; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000276:immunology / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000150:complications / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007003:Hypoglycemia / Q000517:prevention & control; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects* / Q000276:immunology; D011183:Postoperative Complications / Q000276:immunology / Q000517:prevention & control*; D011788:Quality of Life
chemical_list: D007166:Immunosuppressive Agents
keywords: hypoglycaemia; islet transplantation; type 1 diabetes