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Islet cell transplantation for the treatment of type 1 diabetes: recent advances and future challenges

Authors Bruni A, Gala-Lopez B, Pepper AR, Abualhassan NS, Shapiro AMJ

Received 30 January 2014

Accepted for publication 21 February 2014

Published 23 June 2014 Volume 2014:7 Pages 211—223

DOI https://doi.org/10.2147/DMSO.S50789

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 6


Video abstract presented by AM James Shapiro.

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Anthony Bruni, Boris Gala-Lopez, Andrew R Pepper, Nasser S Abualhassan, AM James Shapiro

Clinical Islet Transplant Program and Department of Surgery, University of Alberta, Edmonton, AB, Canada

Abstract: Islet transplantation is a well-established therapeutic treatment for a subset of patients with complicated type I diabetes mellitus. Prior to the Edmonton Protocol, only 9% of the 267 islet transplant recipients since 1999 were insulin independent for >1 year. In 2000, the Edmonton group reported the achievement of insulin independence in seven consecutive patients, which in a collaborative team effort propagated expansion of clinical islet transplantation centers worldwide in an effort to ameliorate the consequences of this disease. To date, clinical islet transplantation has established improved success with insulin independence rates up to 5 years post-transplant with minimal complications. In spite of marked clinical success, donor availability and selection, engraftment, and side effects of immunosuppression remain as existing obstacles to be addressed to further improve this therapy. Clinical trials to improve engraftment, the availability of insulin-producing cell sources, as well as alternative transplant sites are currently under investigation to expand treatment. With ongoing experimental and clinical studies, islet transplantation continues to be an exciting and attractive therapy to treat type I diabetes mellitus with the prospect of shifting from a treatment for some to a cure for all.

Keywords: islet transplantation, type I diabetes mellitus, Edmonton Protocol, engraftment, immunosuppression

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