Overcoming the Challenges Now Limiting Islet Transplantation

@article{Pileggi2006OvercomingTC,
  title={Overcoming the Challenges Now Limiting Islet Transplantation},
  author={Antonello Pileggi and Lorenzo Cobianchi and Luca A Inverardi and Camillo Ricordi},
  journal={Annals of the New York Academy of Sciences},
  year={2006},
  volume={1079}
}
Abstract:  Steady improvements in islet cell processing technology and immunosuppressive protocols have made pancreatic islet transplantation a clinical reality for the treatment of patients with Type 1 diabetes mellitus (T1DM). Recent trials are showing that improved glycemic metabolic control, prevention of severe hypoglycemia, and better quality of life can be reproducibly achieved after transplantation of allogeneic islets in patients with unstable T1DM. Despite these encouraging results… Expand
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References

SHOWING 1-10 OF 120 REFERENCES
Islet transplantation: steady progress and current challenges
TLDR
The benefits of islet transplantation in managing patients with diabetes are tangible and very encouraging data are emerging from the numerous clinical trials and from translational research ongoing worldwide that justify cautious optimism for the near future. Expand
Clinical islet transplantation: advances and immunological challenges
TLDR
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. Expand
Update on Regulatory Issues in Pancreatic Islet Transplantation
TLDR
The manufacturing challenges, discussed by the FDA advisory committee, that remain to be resolved before allogeneic islets can be approved for treatment of type 1 diabetes are highlighted. Expand
Twenty years of clinical islet transplantation at the Diabetes Research Institute--University of Miami.
TLDR
It has been a long journey and despite the intermediate success, more work is needed in order to achieve the ultimate goal of a safe and long-lasting treatment for patients with T1DM. Expand
The Portal Immunosuppressive Storm: Relevance to Islet Transplantation?
TLDR
A "portal storm" of immunosuppressant levels as well as area under the curve were dramatically elevated in portal blood relative to systemic levels for all drugs tested, suggesting that intrahepatic islet transplantation may not be optimal when these agents are absorbed via the portal vein. Expand
Reduced fear of hypoglycemia in successful islet transplantation.
TLDR
Before making this treatment available to a larger number of people with type 1 diabetes, measures of quality of care and of clinical effectiveness must be incorporated to fully evaluate the benefit of this treatment. Expand
Islet Transplantation in Type 1 Diabetes Mellitus Using Cultured Islets and Steroid‐Free Immunosuppression: Miami Experience
  • T. Froud, C. Ricordi, +12 authors R. Alejandro
  • Medicine
  • American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2005
TLDR
It is demonstrated that transplantation of cultured human islet allografts results in reproducible insulin independence in all subjects under this immunosuppressive regimen, comparable to that of freshly transplanted islets (Edmonton protocol). Expand
Achievement of insulin independence in three consecutive type-1 diabetic patients via pancreatic islet transplantation using islets isolated at a remote islet isolation center
TLDR
A collaborative islet transplant program between two geographically distant transplant centers is established and early data demonstrate that pancreatic islets remain viable after shipment to remote transplant sites and insulin independence via PIT can be achieved using a remote pancreaticIslet isolation center. Expand
Requirements for success in clinical islet transplantation.
TLDR
The future success and large scale applicability of islet transplantation will rely on the synergistic research progress in critical areas that contribute to the sequential and integrated approach required for success in clinical islet transplation. Expand
Single-donor, marginal-dose islet transplantation in patients with type 1 diabetes.
TLDR
The tested transplant protocol restored insulin independence and protected against hypoglycemia after single-donor, marginal-dose islet transplantation in 8 of 8 recipients, and may be related to improved islet engraftment secondary to peritransplant administration of antithymocyte globulin and etanercept. Expand
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