Clinical pancreatic islet transplantation

  title={Clinical pancreatic islet transplantation},
  author={A M James Shapiro and Marta Pokrywczyńska and Camillo Ricordi},
  journal={Nature Reviews Endocrinology},
Clinical pancreatic islet transplantation can be considered one of the safest and least invasive transplant procedures. Remarkable progress has occurred in both the technical aspects of islet cell processing and the outcomes of clinical islet transplantation. With >1,500 patients treated since 2000, this therapeutic strategy has moved from a curiosity to a realistic treatment option for selected patients with type 1 diabetes mellitus (that is, those with hypoglycaemia unawareness, severe… 
Clinical islet transplantation: is the future finally now?
Implementation of novel immunosuppression, antiinflammatories, first-in-human stem cell and extrahepatic transplant site trials into clinical investigation has positioned islet transplantation to become the mainstay treatment for all T1DM patients in the near future.
Islet transplantation 30 years after the first transplants.
Scientific advances, as well as economical efforts, are required to make this procedure a real therapeutical option for patients with type 1 diabetes mellitus.
Current state and future evolution of pancreatic islet transplantation
Good therapeutic effects of islet transplantation as a result of accurate blood glucose level–reactive insulin secretion, which cannot be reproduced by current drug therapy, have been confirmed.
Pancreatectomy, Islet Cell Transplantation, and Nutrition Considerations.
The benefits of performing the clinical islet transplantation on a subgroup of patients with type 1 diabetes and pancreatitis are highlighted and new data are summarized that identify the pivotal role of nutrition support as a critical intervention in their management.
Islet Transplantation Alone Versus Solitary Pancreas Transplantation: an Outcome-Driven Choice?
Both outcome-driven and non-outcome-driven criteria are considered in the conclusions, in an attempt to streamline indications for islet-alone or pancreas-alone transplantation.
Carbon Monoxide in Pancreatic Islet Transplantation: A New Therapeutic Alternative to Patients With Severe Type 1 Diabetes Mellitus
Clinical translation of promising experimental findings that serve to lay the foundation for CO in islet transplantation to replace the role of insulin therapy, and thus acting as a cure for type 1 diabetes mellitus and preventing long-term diabetic complications are discussed.
Update on islet cell transplantation
This review provides an update on islet cell transplantation, focusing on recent clinical experience, ongoing research, and future challenges, and demonstrates advances in terms of long-term glycemic control, improved insulin independence rates, and novel approaches to eliminate chronic immunosuppression requirements after isletcell transplantation.
Immunological aspects of allogeneic pancreatic islet transplantation: a comparison between mouse and human
The causes leading to diabetes are analyzed and the immunological mechanisms responsible for rejection between mouse and human are compared and a better understanding of the experimental mouse models should facilitate translation to human clinical application.
Transplantation: Pancreatic and Islet Cells


The Clinical Impact of Islet Transplantation
Recent data indicate that restoration of insulin secretion after islet cell transplantation is associated with an improvement in quality of life, with a reduction in hypoglycemic episodes and potentially with a Reduction in long‐term diabetic complications.
State of the Art of Clinical Islet Transplantation and Novel Protocols of Immunosuppression
Emerging data confirm that islet transplantation can stabilize and reverse several secondary diabetic complications similar to whole pancreas transplantation, but larger, head-to-head trials are needed to compare islet transplants with best medical therapies.
Role of imaging in clinical islet transplantation.
  • G. Low, N. Hussein, A. Shapiro
  • Medicine
    Radiographics : a review publication of the Radiological Society of North America, Inc
  • 2010
Even in patients who lose insulin independence, islet transplantation is considered successful because it provides improved glycemic control and a higher quality of life.
Clinical islet transplantation: advances and immunological challenges
The history of and recent progress in the field, as well as the present immunological challenges and possible strategies for tolerance induction that are crucial to make clinical islet transplantation more widely available are outlined.
Fresh human islet transplantation to replace pancreatic endocrine function in type 1 diabetic patients
Results show that an adequate number of human islets injected intraportally in type 1 diabetic patients can replace the pancreatic endocrine function and can lead to insulin independence.
Islet transplantation in type 1 diabetes: ongoing challenges, refined procedures, and long-term outcome.
  • A. Shapiro
  • Medicine, Biology
    The review of diabetic studies : RDS
  • 2012
The next wave of innovative clinical trial interventions will address instant blood-mediated inflammatory reaction (IBMIR), apoptosis, and inflammation, and will translate into further marked improvements in single-donor success.
Current indications for pancreas or islet transplant
In the setting of well‐controlled diabetes and intact renal function, it is difficult to justify pancreas or islet transplant alone given the risks of immunosuppression.
Total Pancreatectomy with Islet Autologous Transplantation: The Cure for Chronic Pancreatitis?
This review will focus on the current status of total pancreatectomy with autologous islet cell transplant including patient selection, technical considerations, and outcomes.
Achieving and maintaining insulin independence in human islet transplant recipients.
  • B. Hering
  • Medicine, Biology
  • 2005
Maintaining insulin independence will be a different challenge requiring us to clarify whether failure of initially successful islet allografts in type 1 diabetes is related to 1) failure of immunosuppressive regimens to control alloimmunity and autoimmunities.
International trial of the Edmonton protocol for islet transplantation.
Islet transplantation with the use of the Edmonton protocol can successfully restore long-term endogenous insulin production and glycemic stability in subjects with type 1 diabetes mellitus and unstable control, but insulin independence is usually not sustainable.