Human islet cell transplantation: New perspectives for an old challenge

Research output: Contribution to journalReview article

41 Scopus citations

Abstract

Few areas of biomedical research have raised such hope and, over time, led to such frustration as islet cell transplantation. Nevertheless, substantial and definitive progress has occurred in the field. Since 1990, techniques and reagents for high-yield recovery of islets from human pancreases have resulted in a renewed interest in clinical islet transplantation. Some diabetic recipients became completely free from exogenous insulin therapy, and islet function has been maintained for years. The majority of recipients, however, did not become insulin independent or eventually returned to insulin therapy. Glycemic control generally improved in recipients of functioning islet grafts, compared with the degree of metabolic control preceding the islet allografts. Long-term metabolic control was in fact similar or even better than that observed in patients undergoing intensive insulin therapy. The levels of HbA(1c) were maintained in the normal or near-normal range for several years. This was important, since it was unknown whether intrahepatic islet allografts could function long term in an ectopic site. However, the continuous requirement for immunosuppressive drugs still limits the applicability of islet transplantation. Besides the need to eliminate continuous immunosuppression, critical issues that need to be resolved include the development of techniques to reduce islet cell loss after purification and the problem of primary nonfunction, which results from the nonspecific inflammatory response to allogeneic islets at the transplant site.

Original languageEnglish (US)
Pages (from-to)356-369
Number of pages14
JournalDiabetes Reviews
Volume4
Issue number3
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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