title: Evolution of Islet Transplantation for the Last 30 Years.
abstract: In this article, we will review the changes that have occurred in islet transplantation at the birth of Pancreas 30 years ago. The first attempts at β-cell replacement in humans, pancreas and islet transplantation, were performed in the 1960s and 1970s. Although pancreas transplantation has been an accepted treatment for severe labile diabetes predating the emergence of the journal, allogeneic islet transplantation remains experimental. Current investigations within islet transplantation focus to improve islet function after transplantation. Improving islet viability during isolation, exploring ways to increase engraftment, and protection from the host immune system are some of the goals of these investigative efforts. The major barriers to clinical islet transplantation are shortage of human pancreas, the need for immunosuppression, and the inadequacy of the islet isolation process. It is generally accepted that islet encapsulation is an immunoisolation tool with good potential to address the first 2 of those barriers. We have therefore devoted a major part of this review to the critical factors needed to make it a clinical reality. With improved islet isolation techniques and determination of the best site of engraftment as well as improved encapsulation techniques, we hope that islet transplantation could someday achieve routine clinical use.
authors.affiliation: From the *Department of General Surgery, Wake Forest Institute of Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, NC; †Department of Surgery, University of Minnesota School of Medicine, Minneapolis, MN; and ‡Wake Forest Institute of Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Farney
authors.forename: David E R
authors.initials: DE
authors.lastname: Sutherland
authors.forename: Emmanuel C
authors.initials: EC
authors.lastname: Opara
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004059:Diffusion of Innovation; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D007515:Islets of Langerhans / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000266:history / Q000639:trends; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents; D007328:Insulin