Islet transplantation and results

C. Ricordi, Antonello Pileggi

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Intensive treatment with exogenous insulin in combination with diet and exercise in most patients enables good glycemic control and prevents or delays the onset of the dreadful complications associated with chronic unstable glycemia [1]. However, intensive insulin therapy is unable to sustain euglycemia throughout the day and is associated with a threefold increased risk of severe, life-threatening hypoglycemic episodes [1]. Steady progress has been achieved in the recent years in the field of ®-cell replacement by transplantation of pancreatic islets to restore insulin production in patients with diabetes [2]. Islet cells sense variations in glycemic values and accordingly synthesize and secrete endocrine hormones (namely, insulin and glucagon) in real time when needed; proper islet function allows for a more physiological glycemic control throughout the day when compared to exogenous insulin. Since the pioneering experiments performed by Ballinger and Lacy in the early 1970s [3], steady progress has been recorded in the fields of human islet isolation and transplantation technology [4-18]. Transplantation of islets of Langerhans can improve metabolic control, normalizing glycemic values, reducing glycated hemoglobin (HbA1c), and preventing the occurrence of severe hypoglycemia when sufficient islet numbers are implanted [4, 6-17]. Similar benefits, including absence of severe hypoglycemia, are observed even after transplantation of suboptimal islet numbers, the patient thus requiring exogenous insulin administration at doses lower than pretransplantation in order to maintain excellent glycemic control [4, 6-17].

Original languageEnglish (US)
Title of host publicationDiseases of the Pancreas
Subtitle of host publicationCurrent Surgical Therapy
PublisherSpringer Berlin Heidelberg
Pages913-920
Number of pages8
ISBN (Print)9783540286554
DOIs
StatePublished - Dec 1 2008

ASJC Scopus subject areas

  • Medicine(all)

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