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Human islet cell transplantation--future prospects.

S A White¹, R F James, S M Swift

¹Department of Surgery, University of Leicester, Leicester, UK. steve_islets@hotmail.com

Diabetic Medicine : a Journal of the British Diabetic Association

|March 17, 2001

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Achieving insulin independence after islet allotransplantation remains challenging due to immunosuppression and islet mass issues. However, refined protocols show promise for treating diabetes mellitus.

Area of Science:

Endocrinology
Transplantation Immunology
Regenerative Medicine

Background:

Islet transplantation offers a potential cure for diabetes mellitus.
Clinical success in islet allotransplantation lags behind small animal models.
Significant challenges hinder achieving long-term insulin independence in patients.

Purpose of the Study:

To review and discuss the reasons for difficulties in achieving insulin independence after islet allotransplantation.
To analyze factors contributing to the limited success of clinical islet allotransplantation.

Main Methods:

Comprehensive literature review of Medline from 1975 to July 2000.
Analysis of data from the International Islet Transplant Registry (ITR) up to December 1998.

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Main Results:

405 islet allotransplants reported to ITR by December 1998.
Only 12% of documented transplants (1990-1998) achieved insulin independence.
Refined peri-transplant protocols improved 1-year insulin independence to 20%.

Conclusions:

Factors limiting success include diabetogenic immunosuppression, insufficient islet mass, and ectopic transplant sites.
Despite challenges, islet allotransplantation holds significant potential as a diabetes treatment.
Recent advancements suggest a more established role for islet allotransplantation in managing diabetes mellitus.