Ann Pediatr Endocrinol Metab.  2021 Jun;26(2):86-91. 10.6065/apem.2142012.006.

Pancreas transplant in type 1 diabetes mellitus: the emerging role of islet cell transplant

• Kochar IS
• Jain R

• KMID: 2517585
• DOI: http://doi.org/10.6065/apem.2142012.006

Abstract

Pancreas transplant, both whole pancreas and islet cell, is a known therapeutic option for treatment of type 1 diabetes mellitus. Islet cell transplant began as an experimental therapy but is emerging to be quite beneficial due to less surgical risk and fewer complications. It is also considered a promising option in pediatric patients. In this review the authors discuss the indications, procedure, and benefits of islet cell transplant along with newer strategies for improving outcomes.

Keyword

Pancreas transplant; Islet cell; Type 1 diabetes; Pediatric diabetes; Hypoglycemia

Reference

References

1. Das AK. Type 1 diabetes in India: overall insights. Indian J Endocrinol Metab. 2015; 19(Suppl 1):S31–3.

2. Dholakia S, Oskrochi Y, Easton G, Papalois V. Advances in pancreas transplantation. J R Soc Med. 2016; 109:141–6.

3. Cryer PE. Hypoglycemia in type 1 diabetes mellitus. Endocrinol Metab Clin North Am. 2010; 39:641–54.

4. Lerner SM. Kidney and pancreas transplantation in type 1 diabetes mellitus. Mt Sinai J Med. 2008; 75:372–84.

5. Anazawa T, Okajima H, Masui T, Uemoto S. Current state and future evolution of pancreatic islet transplantation. Ann Gastroenterol Surg. 2018; 3:34–42.

6. Bottino R, Knoll MF, Knoll CA, Bertera S, Trucco MM. The future of islet transplantation is now. Front Med (Lausanne). 2018; 5:202.

7. Srinivasan P, Huang GC, Amiel SA, Heaton ND. Islet cell transplantation. Postgrad Med J. 2007; 83:224–9.

8. Ricordi C, Lacy PE, Scharp DW. Automated islet isolation from human pancreas. Diabetes. 1989; 38 Suppl 1:140–2.

9. Matsumoto S, Noguchi H, Naziruddin B, Onaca N, Jackson A, Nobuyo H, et al. Improvement of pancreatic islet cell isolation for transplantation. Proc (Bayl Univ Med Cent). 2007; 20:357–62.

10. Gruessner AC. 2011 update on pancreas transplantation: comprehensive trend analysis of 25,000 cases followed up over the course of twenty-four years at the International Pancreas Transplant Registry (IPTR). Rev Diabet Stud. 2011; 8:6–16.

11. Rickels MR, Robertson RP. Pancreatic islet transplantation in humans: recent progress and future directions. Endocr Rev. 2019; 40:631–68.

12. Sutherland DE, Radosevich DM, Bellin MD, Hering BJ, Beilman GJ, Dunn TB, et al. Total pancreatectomy and islet autotransplantation for chronic pancreatitis. J Am Coll Surg. 2012; 214:409–24.

13. Ponte GM, Pileggi A, Messinger S, Alejandro A, Ichii H, Baidal DA, et al. Toward maximizing the success rates of human islet isolation: influence of donor and isolation factors. Cell Transplant. 2007; 16:595–607.

14. Ventura-Aguiar P, Ferrer-Fábrega J, José Ricart M. Pancreas transplantation. In : Tsoulfas G, editor. Organ donation and transplantation - current status and future challenges. London: IntechOpen;2018. p. 259–88.

15. Agarwal A, Brayman KL. Update on islet cell transplantation for type 1 diabetes. Semin Intervent Radiol. 2012; 29:90–8.

16. Ihm SH, Matsumoto I, Sawada T, Nakano M, Zhang HJ, Ansite JD, et al. Effect of donor age on function of isolated human islets. Diabetes. 2006; 55:1361–8.

17. Niclauss N, Bosco D, Morel P, Demuylder-Mischler S, Brault C, Milliat-Guittard L, et al. Influence of donor age on islet isolation and transplantation outcome. Transplantation. 2011; 91:360–6.

18. Nanji SA, Shapiro AM. Advances in pancreatic islet transplantation in humans. Diabetes Obes Metab. 2006; 8:15–25.

19. Lakey JR, Warnock GL, Rajotte RV, Suarez-Alamazor ME, Ao Z, Shapiro AM, et al. Variables in organ donors that affect the recovery of human islets of Langerhans. Transplantation. 1996; 61:1047–53.

20. Lakey JR, Rajotte RV, Warnock GL, Kneteman NM. Human pancreas preservation prior to islet isolation. Cold ischemic tolerance. Transplantation. 1995; 59:689–94.

21. Shapiro AM, Lakey JR, Ryan EA, Korbutt GS, Toth E, Warnock GL, et al. Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. N Engl J Med. 2000; 343:230–8.

22. Hughes SJ, Clark A, McShane P, Contractor HH, Gray DW, Johnson PR. Characterisation of collagen VI within the islet-exocrine interface of the human pancreas: implications for clinical islet isolation? Transplantation. 2006; 81:423–6.

23. Shapiro AM. Islet transplantation in type 1 diabetes: ongoing challenges, refined procedures, and long-term outcome. Rev Diabet Stud. 2012; 9:385–406.

24. Markmann JF, Tomaszewski J, Posselt AM, Levy MM, Woehrle M, et al. The effect of islet cell culture in vitro at 24 degrees C on graft survival and MHC antigen expression. Transplantation. 1990; 49:272–7.

25. Baidal DA, Froud T, Ferreira JV, Khan A, Alejandro R, Ricordi C. The bag method for islet cell infusion. Cell Transplant. 2003; 12:809–13.

26. Shapiro AM, Pokrywczynska M, Ricordi C. Clinical pancreatic islet transplantation. Nat Rev Endocrinol. 2017; 13:268–77.

27. Collaborative Islet Transplant Registry. Eighth annual report [Internet]. Collaborative Islet Transplant Registry; 2014 [cited 2020 Aug 17]. Available from: www.citregistry.org.

28. Shapiro AM, Ricordi C, Hering BJ, Auchincloss H, Lindblad R, Robertson RP, et al. International trial of the Edmonton protocol for islet transplantation. N Engl J Med. 2006; 355:1318–30.

29. Bellin MD, Barton FB, Heitman A, Harmon JV, Kandaswamy R, Balamurugan AN, et al. Potent induction immunotherapy promotes long-term insulin independence after islet transplantation in type 1 diabetes. Am J Transplant. 2012; 12:1576–83.

30. Berney T, Ferrari-Lacraz S, Bühler L, Oberholzer J, Marangon N, Philippe J, et al. Long-term insulinindependence after allogeneic islet transplantation for type 1 diabetes: over the 10-year mark. Am J Transplant. 2009; 9:419–23.

31. Hering BJ, Kandaswamy R, Ansite JD, Eckman PM, Nakano M, Sawada T, et al. Single-donor, marginal-dose islet transplantation in patients with type 1 diabetes. JAMA. 2005; 293:830–5.

32. Foster NC, Miller KM, Tamborlane WV, Bergenstal RM, Beck RW; T1D Exchange Clinic Network. Continuous glucose monitoring in patients with type 1 diabetes using insulin injections. Diabetes Care. 2016; 39:e81–2.

33. Hering BJ, Clarke WR, Bridges ND, Eggerman TL, Alejandro R, Bellin MD, et al. Phase 3 trial of transplantation of human islets in type 1 diabetes complicated by severe hypoglycemia. Diabetes Care. 2016; 39:1230–40.

34. Bellin MD, Carlson AM, Kobayashi T, Gruessner AC, Hering BJ, Moran A, et al. Outcome after pancreatectomy and islet autotransplantation in a pediatric population. J Pediatr Gastroenterol Nutr. 2008; 47:37–44.

35. Chinnakotla S, Bellin MD, Schwarzenberg SJ, Radosevich DM, Cook M, Dunn TB, et al. Total pancreatectomy and islet autotransplantation in children for chronic pancreatitis: indication, surgical techniques, postoperative management, and long-term outcomes. Ann Surg. 2014; 260:56–64.

36. Wahoff DC, Papalois BE, Najarian JS, Kendall DM, Farney AC, Leone JP, et al. Autologous islet transplantation to prevent diabetes after pancreatic resection. Ann Surg. 1995; 222:562–75.

37. Zakrzewski W, Dobrzyński M, Szymonowicz M, Rybak Z. Stem cells: past, present, and future. Stem Cell Res Ther. 2019; 10:68.

38. Song S, Roy S. Progress and challenges in macroencapsulation approaches for type 1 diabetes (T1D) treatment: cells, biomaterials, and devices. Biotechnol Bioeng. 2016; 113:1381–402.

39. Rother KI, Harlan DM. Challenges facing islet transplantation for the treatment of type 1 diabetes mellitus. J Clin Invest. 2004; 114:877–83.

40. Ryan EA, Paty BW, Senior PA, Bigam D, Alfadhli E, Kneteman NM, et al. Five-year follow-up after clinical islet transplantation. Diabetes. 2005; 54:2060–9.

41. Kenmochi T, Asano T, Maruyama M, Saigo K, Akutsu N, Iwashita C, et al. Clinical islet transplantation in Japan. J Hepatobiliary Pancreat Surg. 2009; 16:124–30.

42. Johnston PC, Lin YK, Walsh RM, Bottino R, Stevens TK, Trucco M, et al. Factors associated with islet yield and insulin independence after total pancreatectomy and islet cell autotransplantation in patients with chronic pancreatitis utilizing off-site islet isolation: Cleveland Clinic experience. J Clin Endocrinol Metab. 2015; 100:1765–70.

43. Hering BJ, Clarke WR, Bridges ND, Eggerman TL, Alejandro R, Bellin MD, et al. Phase 3 trial of transplantation of human islets in type 1 diabetes complicated by severe hypoglycemia. Diabetes Care. 2016; 39:1230–40.

44. Collaborative Islet Transplant Registry. Tenth annual report [Internet]. Collaborative Islet Transplant Registry. 2015 [cited 2021 Feb 19]. Available from: www.citregistry.org.

45. Bellin MD, Forlenza GP, Majumder K, Berger M, Freeman ML, Beilman GJ, et al. Total pancreatectomy with islet autotransplantation resolves pain in young children with severe chronic pancreatitis. J Pediatr Gastroenterol Nutr. 2017; 64:440–5.

46. Kirstie K, Danielson , Rebecca S, Monson , Li Y, Oberholzer J, et al. 117-OR: Islet cell transplantation for type 1 diabetes: The UIC experience, 2004-2020. Diabetes. 2020; 69:(Supplement 1).