Current issues in allogeneic islet transplantation

  title={Current issues in allogeneic islet transplantation},
  author={Charles A Chang and Michael C. Lawrence and Bashoo Naziruddin},
  journal={Current Opinion in Organ Transplantation},
Purpose of review Transplantation of allogenic pancreatic islets is a minimally invasive treatment option to control severe hypoglycemia and dependence on exogenous insulin among type 1 diabetes (T1D) patients. This overview summarizes the current issues and progress in islet transplantation outcomes and research. Recent findings Several clinical trials from North America and other countries have documented the safety and efficacy of clinical islet transplantation for T1D patients with impaired… 
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.
Advances in Pancreatic Islet Transplantation Sites for the Treatment of Diabetes
Developing new transplantation sites with emerging technologies to improve islet graft survival and simplify immune regulation will greatly benefit the future success of islet cell therapy in the treatment of diabetes.
Immune Protection of Stem Cell-Derived Islet Cell Therapy for Treating Diabetes
There is a significant need for novel approaches to the large-scale generation of functional human islets protected from autoimmune rejection in order to ensure durable graft acceptance without immunosuppression in patients with type 1 diabetes.
Artificial Pancreas or Novel Beta-Cell Replacement Therapies: a Race for Optimal Glycemic Control?
Closed loop insulin delivery devices are promising treatment strategies and are likely to be used in clinical practice in the short term, but this approach will always suffer from delays in glucose measurement and insulin action preventing it from normalizing glycemic control.
Allo- and auto-percutaneous intra-portal pancreatic islet transplantation (PIPIT) for diabetes cure and prevention: the role of imaging and interventional radiology.
Results of the Collaborative Islet Transplant Registry (CITR) demonstrate that allo-PIPIT reduces episodes of hypoglycemia and diabetic complications, and improves quality of life of diabetic patients.
Will Genetic Engineering Carry Xenotransplantation of Pig Islets to the Clinic?
This review summarizes the current issues and progress in islet xenotransplantation with special emphasis on genetically modified/gene edited donor pigs.
T Cell-Mediated Beta Cell Destruction: Autoimmunity and Alloimmunity in the Context of Type 1 Diabetes
It is hypothesize that a better understanding of autoreactive T cell targets during disease pathogenesis and alloimmunity following transplant destruction could enhance attempts to re-establish tolerance to beta cells.


Insulin Independence After Islet Transplantation Into Type I Diabetic Patient
The first type I diabetic patient with an established kidney transplant on basal cyclosporin immunosuppression who was able to eliminate the insulin requirement after human islet transplantation into the portal vein is reported, representing the first essential step required to determine the feasibility of islet transplants by future clinical trials.
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.
Phase 3 Trial of Transplantation of Human Islets in Type 1 Diabetes Complicated by Severe Hypoglycemia
Transplanted PHPI provided glycemic control, restoration of hypoglycemia awareness, and protection from SHEs in subjects with intractable IAH and SHEs and should be considered for patients with T1D and IAH in whom other, less invasive current treatments have been ineffective in preventing SHEs.
Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen.
The observations in patients with type 1 diabetes indicate that islet transplantation can result in insulin independence with excellent metabolic control when glucocorticoid-free immunosuppression is combined with the infusion of an adequate islet mass.
Diabetes Is Reversed in a Murine Model by Marginal Mass Syngeneic Islet Transplantation Using a Subcutaneous Cell Pouch Device
The CP is biocompatible, forms an environment suitable for islet engraftment, and offers a potential alternative to the intraportal site for islets and future stem cell therapies.
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.
Long term Glycemic Control Using Polymer Encapsulated, Human Stem-Cell Derived β-cells in Immune Competent mice
The first long-term glycemic correction of a diabetic, immunocompetent animal model using human SC-β cells is reported, which induced glycemic Correction without any immunosuppression until their removal at 174 d after implantation.
Potent Induction Immunotherapy Promotes Long‐Term Insulin Independence After Islet Transplantation in Type 1 Diabetes
  • M. Bellin, F. Barton, B. Hering
  • Biology, Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2012
Findings support potential for long‐term insulin independence after ITA using potent induction therapy, with anti‐CD3 Ab or TCDAb+TNF‐α‐i.
Financial Issues Constraining the Use of Pancreata Recovered for Islet Transplantation: A White Paper
A consensus document supported by a diverse group of stakeholders in islet transplantation to suggest actions to address the complex financial cost accounting issues that pose undue burden on organ procurement organizations and transplant centers trying to manage the costs of the pancreata from deceased donors needed to isolate islets.
Current stem cell based therapies in diabetes.
This review will focus on the progress and remaining obstacles in diabetes related stem cell research, and will specifically discuss approaches using embryonic, induced pluripotent, germline and mesenchymal derived stem cells.