title: Insulin replacement therapy in patients with type 1 diabetes by isolated pancreatic islet transplantation.
abstract: Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia which causes micro- and macrovascular complications. A significant increase in diabetes morbidity rate has been observed. It is estimated that in year 2030 there will be 552 million diabetics worldwide. Type 1 diabetes requires lifelong treatment with insulin. The only available treatment of diabetes restoring physiological glucose metabolism is transplantation of pancreatic beta cells in form of pancreas or isolated pancreatic islets transplantation. The treatment restores normoglycemia and reduces chances of complications of diabetes. Over the past 10 years there has been significant progress in the development of the islet transplantation procedure. Constant improvement of the method, in particular the development of islets isolation and sourcing techniques, shows promise. According to the Collaborative Islet Transplant Registry in 1999-2009, there have been performed 1,072 allotransplantations. This paper summarizes the indications and contraindications for the procedure, the transplantation process, as well as the surgical procedure and immunosuppressive treatment. The review presents problems related to pancreatic islet cells transplantation and standard scheme of immunosuppressive treatment, requiring a solution.
authors.affiliation: Department of Gastroenterology and Metabolic Diseases, Medical University of Warsaw, Banacha la, 02-097 Warszawa, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Poradzka
authors.affiliation: Student Scientific Organisation APEX of Department of General and Transplantation Surgery, Medical University of Warsaw, Nowogrodzka 59, 02-006 Warszawa, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Wroński
authors.affiliation: Department of Gastroenterology and Metabolic Diseases, Medical University of Warsaw, Banacha la, 02-097 Warszawa, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Jasik
authors.affiliation: Department of Gastroenterology and Metabolic Diseases, Medical University of Warsaw, Banacha la, 02-097 Warszawa, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Karnafel
authors.affiliation: Department of General and Transplantation Surgery, Transplantation Institute,Medical University of Warsaw, Nowogrodzka 59, 02-006 Warszawa, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Fiedor
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000401:mortality; D018579:Patient Selection; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007166:Immunosuppressive Agents; D007328:Insulin