Diabetes Metab J.  2011 Jun;35(3):199-206. 10.4093/dmj.2011.35.3.199.

Clinical Allogeneic and Autologous Islet Cell Transplantation: Update

Affiliations
  • 1Baylor Research Institute, Dallas, TX, USA. shinichi41@mac.com

Abstract

Islet cell transplantation is categorized as a beta-cell replacement therapy for diabetic patients who lack the ability to secrete insulin. Allogeneic islet cell transplantation is for the treatment of type 1 diabetes, and autologous islet cell transplantation is for the prevention of surgical diabetes after a total pancreatectomy. The issues of allogeneic islet cell transplantation include poor efficacy of islet isolation, the need for multiple donor pancreata, difficulty maintaining insulin independence and undesirable side effects of immunosuppressive drugs. Those issues have been solved step by step and allogeneic islet cell transplantation is almost ready to be the standard therapy. The donor shortage will be the next issue and marginal and/or living donor islet cell transplantation might alleviate the issue. Xeno-islet cell transplantation, beta-cell regeneration from human stem cells and gene induction of the naive pancreas represent the next generation of beta-cell replacement therapy. Autologous islet cell transplantation after total pancreatectomy for the treatment of chronic pancreatitis with severe abdominal pain is the standard therapy, even though only limited centers are able to perform this treatment. Remote center autologous islet cell transplantation is an attractive option for hospitals performing total pancreatectomies without the proper islet isolation facilities.

Keyword

Allogeneic islet cell transplantation; Autologous islet cell transplantation; Diabetes mellitus, type 1; Pancreatitis, chronic; SUITO index

MeSH Terms

Abdominal Pain
Cell Transplantation
Diabetes Mellitus, Type 1
Humans
Insulin
Islets of Langerhans
Living Donors
Pancreas
Pancreatectomy
Pancreatitis, Chronic
Regeneration
Stem Cells
Tissue Donors
Transplants
Insulin

Figure

  • Fig. 1 Centers for autologous islet cell transplantation in the world. Currently only limited centers perform the autologous islet cell transplantation to prevent surgical diabetes.


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