Insulin replacement therapy in patients with type 1 diabetes by isolated pancreatic islet transplantation

Acta Pol Pharm. 2013 Nov-Dec;70(6):943-50.

Abstract

Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia which causes micro- and macrovascular complications. A significant increase in diabetes morbidity rate has been observed. It is estimated that in year 2030 there will be 552 million diabetics worldwide. Type 1 diabetes requires lifelong treatment with insulin. The only available treatment of diabetes restoring physiological glucose metabolism is transplantation of pancreatic beta cells in form of pancreas or isolated pancreatic islets transplantation. The treatment restores normoglycemia and reduces chances of complications of diabetes. Over the past 10 years there has been significant progress in the development of the islet transplantation procedure. Constant improvement of the method, in particular the development of islets isolation and sourcing techniques, shows promise. According to the Collaborative Islet Transplant Registry in 1999-2009, there have been performed 1,072 allotransplantations. This paper summarizes the indications and contraindications for the procedure, the transplantation process, as well as the surgical procedure and immunosuppressive treatment. The review presents problems related to pancreatic islet cells transplantation and standard scheme of immunosuppressive treatment, requiring a solution.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / mortality
  • Diabetes Mellitus, Type 1 / surgery*
  • Graft Survival
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Insulin / blood
  • Islets of Langerhans Transplantation* / adverse effects
  • Islets of Langerhans Transplantation* / mortality
  • Patient Selection
  • Treatment Outcome

Substances

  • Blood Glucose
  • Immunosuppressive Agents
  • Insulin