Islet Cell Transplantation

An estimated 177 million people worldwide suffer from diabetes. Insulin administration controls the day-to-day problems of this disease but glucose homeostasis is not fully normalized with insulin replacement and the long-term complications caused by suboptimal homeostasis are significant. In terms of transplantation, two options exist: whole organ pancreas transplant and isolated islet cell transplant. Whole organ transplantation is favored in patients who also need kidney transplantation or have exocrine deficiency. Islet cell transplantation is usually reserved for patients with brittle diabetes and hypoglycemic unawareness. In this latter group of patients, this procedure can be lifesaving. Additionally, it has a profound beneficial effect on quality of life and secondary complications of diabetes such as neuropathy and nephropathy.

SUGGESTED READINGS

• 1 Frank A, Deng S, Huang X et al.. Transplantation for type I diabetes: comparison of vascularized whole-organ pancreas with isolated pancreatic islets.  Ann Surg. 2004;  240 631-640 discussion 640-643
• 2 Korsgren O, Nilsson B, Berne C et al.. Current status of clinical islet transplantation.  Transplantation. 2005;  79 1289-1293
• 3 Owen R J, Ryan E A, O'Kelly K et al.. Percutaneous transhepatic pancreatic islet cell transplantation in type 1 diabetes mellitus: radiologic aspects.  Radiology. 2003;  229 165-170
• 4 Robertson R P. Successful islet transplantation for patients with diabetes: fact or fantasy?.  N Engl J Med. 2000;  343 289-290
• 5 Shapiro A M, Lakey J R, Ryan E A et al.. Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen.  N Engl J Med. 2000;  343 230-238
• 6 Sutherland D E. Current status of beta-cell replacement therapy (pancreas and islet transplantation) for treatment of diabetes mellitus.  Transplant Proc. 2003;  35 1625-1627