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Pancreatic and islet transplantation
1Departments of Surgery and Medicine, McGill University, and The Centre for Pancreatic Diseases, McGill University Health Centre, Montreal General Hospital, 1650 Cedar Avenue, L9-424, Montreal, Quebec H3G 1A4, Canada. cxlw@musica.mcgill.ca
Diabetes mellitus is the most devastating chronic disease of all time. This review discusses the current therapies for type 1 diabetes that are predicated on the restoration of insulin secretion by transplantation. Recent developments in vascularized pancreas transplantation have led to a dramatic increase in the number of these procedures performed worldwide, with over 10,000 cases reported currently to the International Pancreas Transplant Registry. Although the procedure contributes to a significant improvement in quality of life, compared with traditional insulin therapy, it still suffers from a number of shortcomings, including a persistently high postoperative morbidity rate and the requirement of long-term immunosuppression. Islet transplantation is therefore being pursued actively as an equally efficient means of restoring normoglycemia, but without the attendant morbidity of the whole-organ procedure, and hopefully with a significantly reduced need for immunosuppression.
Diabetes mellitus is the most devastating chronic disease of all time. This review discusses the current therapies for type 1 diabetes that are predicated on the restoration of insulin secretion by transplantation. Recent developments in vascularized pancreas transplantation have led to a dramatic increase in the number of these procedures performed worldwide, with over 10,000 cases reported currently to the International Pancreas Transplant Registry. Although the procedure contributes to a significant improvement in quality of life, compared with traditional insulin therapy, it still suffers from a number of shortcomings, including a persistently high postoperative morbidity rate and the requirement of long-term immunosuppression. Islet transplantation is therefore being pursued actively as an equally efficient means of restoring normoglycemia, but without the attendant morbidity of the whole-organ procedure, and hopefully with a significantly reduced need for immunosuppression.