Clinical islet transplantation: a review

Area of Science:

• Endocrinology and Metabolism
• Transplantation Immunology
• Regenerative Medicine

Background:

• Type 1 diabetes (T1D) management remains challenging due to insulin therapy's limitations in physiological glycemic control.
• Islet transplantation is explored as a therapeutic strategy to restore endogenous insulin production.
• Pancreatectomy necessitates strategies to prevent diabetes, including islet autotransplantation.

Purpose of the Study:

• To review the current literature on islet transplantation for diabetes treatment.
• To present preliminary human islet transplantation data from the University of Geneva.
• To evaluate the efficacy of islet autotransplantation and allotransplantation.

Main Methods:

• Literature review of islet transplantation studies.
• Analysis of outcomes from over 150 islet autotransplantations post-pancreatectomy.
• Analysis of outcomes from over 350 islet allotransplantations.

Main Results:

• Islet autotransplantation achieved insulin independence in nearly 40% of patients following pancreatectomy.
• Islet allotransplantation resulted in improved metabolic control in over 50% of recipients.
• Approximately 20% of islet allotransplantation recipients achieved insulin independence.

Conclusions:

• Islet transplantation, both auto and allo-, represents a significant advancement in managing type 1 diabetes.
• These procedures offer a viable alternative to conventional insulin therapy for select patient populations.
• Further research and data, including from centers like the University of Geneva, are crucial for optimizing outcomes.