Islet cell transplantation has recently emerged as one of the most promising therapeutic approaches to improving glycometabolic control in diabetic patients and, in many cases, achieving insulin independence. Unfortunately, many persistent flaws still prevent islet transplantation from becoming the gold standard treatment for type 1 diabetic patients. We review the state of the art of islet transplantation, outcomes, immunosuppression and - most important - the impact on patients' survival and long-term diabetic complications and eventual alternative options. Finally, we review the many problems in the field and the challenges to islet survival after transplantation. The rate of insulin independence 1 year after islet cell transplantation has significantly improved in recent years (60% at 1 year posttransplantation compared with 15% previously). Recent data indicate that restoration of insulin secretion after islet cell transplantation is associated with an improvement in quality of life, with a reduction in hypoglycemic episodes and potentially with a reduction in long-term diabetic complications. Once clinical islet transplantation has been successfully established, this treatment could even be offered to diabetic patients long before the onset of diabetic complications.

The clinical impact of islet transplantation / P. Fiorina, A.M.J. Shapiro, C. Ricordi, A. Secchi. - In: AMERICAN JOURNAL OF TRANSPLANTATION. - ISSN 1600-6135. - 8:10(2008), pp. 1990-1997. [10.1111/j.1600-6143.2008.02353.x]

The clinical impact of islet transplantation

P. Fiorina;A. Secchi
2008

Abstract

Islet cell transplantation has recently emerged as one of the most promising therapeutic approaches to improving glycometabolic control in diabetic patients and, in many cases, achieving insulin independence. Unfortunately, many persistent flaws still prevent islet transplantation from becoming the gold standard treatment for type 1 diabetic patients. We review the state of the art of islet transplantation, outcomes, immunosuppression and - most important - the impact on patients' survival and long-term diabetic complications and eventual alternative options. Finally, we review the many problems in the field and the challenges to islet survival after transplantation. The rate of insulin independence 1 year after islet cell transplantation has significantly improved in recent years (60% at 1 year posttransplantation compared with 15% previously). Recent data indicate that restoration of insulin secretion after islet cell transplantation is associated with an improvement in quality of life, with a reduction in hypoglycemic episodes and potentially with a reduction in long-term diabetic complications. Once clinical islet transplantation has been successfully established, this treatment could even be offered to diabetic patients long before the onset of diabetic complications.
Immunosuppression; Islet transplantation; Late complications of diabetes; Type 1 diabetes mellitus; Antigens, CD34; Diabetes Mellitus, Type 1; Graft Survival; Humans; Hypoglycemia; Immunosuppressive Agents; Insulin; Islets of Langerhans; Islets of Langerhans Transplantation; Pancreas Transplantation; Quality of Life; Treatment Outcome; Immunology
Settore MED/13 - Endocrinologia
Article (author)
File in questo prodotto:
File Dimensione Formato  
Fiorina_et_al-2008-American_Journal_of_Transplantation.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 370.72 kB
Formato Adobe PDF
370.72 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/557238
Citazioni
  • ???jsp.display-item.citation.pmc??? 80
  • Scopus 180
  • ???jsp.display-item.citation.isi??? 165
social impact