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COMMENTARY Pancreatic Islet Transplantation: An Update

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Abstract:

Clinical islet transplantation has recently received a strong impulse from the results obtained with the introduction of a glucocorticoid-free immunosuppressive regimen leading to insulin independence at 1 year in 100% of the treated patients. Thus, islet transplantation may now be considered as a viable routine option for the treatment of insulin-dependent diabetes mellitus. As an alternative approach to endocrine cell replacement, it displays several potential advantages over whole-organ transplant. Indeed, islet transplantation is at present a minimally invasive procedure and offers for the future the unique possibility of being performed under donor-specific tolerant conditions because islets may potentially be engineered in vitro. In addition, various approaches such as in vitro islet expansion, the use of immortal beta cells, engineered surrogates, or xenogeneic islets could make the availability of donor tissues unlimited. However, most of these approaches are still to be realized in the clinical practice and several problems with the current procedure still need to be addressed to optimize certain aspects, such as organ procurement and preservation, islet isolation and culture, modality of transplant, and immunosuppression. Indeed, pancreata from multiple donors are still needed to guarantee a sufficient islet mass because a substantial number of transplanted islets fails to engraft into the liver. Overcoming these obstacles may dramatically expand the number of transplants and even minor changes applied to the steps of the procedure may produce significant impact in the short run. In light of the renewed enthusiasm in the field, the focus of the present update is to review the articles published in Cell Transplantation since 1999 and to analyze the scientific contribution the journal has made to the field as this new era for islet transplantation begins.

Document Type: Miscellaneous

DOI: http://dx.doi.org/10.3727/000000002783985783

Affiliations: 1: *Department of Internal Medicine, University of Torino, Torino, Italy 2: †Diabetes Research Institute, University of Miami School of Medicine, Miami, FL

Publication date: January 1, 2002

More about this publication?
  • Cell Transplantation publishes original, peer-reviewed research and review articles on the subject of cell transplantation and its application to human diseases. To ensure high-quality contributions from all areas of transplantation, separate section editors and editorial boards have been established. Articles deal with a wide range of topics including physiological, medical, preclinical, tissue engineering, and device-oriented aspects of transplantation of nervous system, endocrine, growth factor-secreting, bone marrow, epithelial, endothelial, and genetically engineered cells, among others. Basic clinical studies and immunological research papers are also featured. To provide complete coverage of this revolutionary field, Cell Transplantation will report on relevant technological advances, and ethical and regulatory considerations of cell transplants. Cell Transplantation is now an Open Access journal starting with volume 18 in 2009, and therefore there will be an inexpensive publication charge, which is dependent on the number of pages, in addition to the charge for color figures. This will allow work to be disseminated to a wider audience and also entitle the corresponding author to a free PDF, as well as prepublication of an unedited version of the manuscript.
cog/ct/2002/00000011/00000004/ct284
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