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Current Challenges in Pancreas and Islet Transplantation: A Scoping Review.
Velimir Altabas1,2, Tomislav Bulum2,3
1Department of Endocrinology, Diabetes and Metabolic Diseases Mladen Sekso, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia.
Biomedicines
|January 8, 2025
Summary
Transplantation for type 1 diabetes shows progress, but challenges like rejection and limited insulin independence persist. Stem cell therapies offer a promising future for beta-cell regeneration and improved diabetes management.
Area of Science:
- Endocrinology and Metabolism
- Immunology
- Regenerative Medicine
Background:
- Type 1 diabetes mellitus (T1DM) is an autoimmune disease requiring lifelong insulin therapy.
- Current management faces challenges including long-term complications and psychological distress.
- Whole-pancreas and islet transplantation offer potential for insulin independence but have limitations.
Purpose of the Study:
- To summarize evidence on insulin independence after T1DM cell transplantation.
- To compare insulin independence rates across whole-pancreas, islet, and stem cell transplantation.
- To identify challenges and future directions for T1DM transplantation therapies.
Main Methods:
- Systematic scoping review of PubMed, Scopus, and Web of Science databases (inception to Nov 2024).
- Inclusion criteria: English, peer-reviewed clinical studies, >10 T1DM patients, ≥1-year follow-up, reporting insulin independence.
- Data extraction focused on transplant type, patient numbers, follow-up duration, and insulin independence rates.
Main Results:
- Identified 48 studies from 1380 initial papers, indicating a growing research field.
- Established transplantation methods show varying success in achieving insulin independence.
- Significant challenges include immunosuppression risks, potential for malignant diseases, and ethical considerations.
Conclusions:
- Existing transplantation techniques for T1DM have limitations, including insufficient insulin independence rates.
- Immunosuppression and surgical risks remain critical concerns.
- Stem cell-derived islet transplantation presents a promising avenue for beta-cell regeneration and improved T1DM management.
