Abstract
Purpose of review
In patients with type 1 diabetes with extreme glycemic variability, the restoration of pancreas endocrine function is potentially and completely achieved with islets of Langerhans (tissue derived from whole organ) or pancreas (whole organ) transplantation. The aim of our review is to report on the latest studies and to highlight the benefits and risks of the two procedures, providing clearer, more selective, evidence-based clinical indications that also consider the impact on the degenerative complications of diabetes as a potential benefit.
Recent findings
Clinical experience in this field has been dynamic over the last three decades, and has been characterized by the development of more standardized protocols and a clearer definition of clinical outcome. On the contrary, the recommendations thus far are not well delineated and tend to overlap, and the past ADA position statement for pancreas transplant alone has also been applied to islet transplant alone, without differentiation.
Summary
Both outcome-driven and non-outcome-driven criteria are considered in the conclusions, in an attempt to streamline indications for islet-alone or pancreas-alone transplantation.
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•• Shapiro AM, Pokrywczynska M, Ricordi C. Clinical pancreatic islet transplantation. Nat Rev Endocrinol. 2017;13(5):268–77. https://doi.org/10.1038/nrendo.2016.178. This review outlines the key points in the development of islet transplantation, giving a clear picture of the state of the art in this field, and enables one to carefully consider the option of islet transplantation for the potential cure of type 1 diabetes.
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Paola Maffi and Antonio Secchi declare that they have no conflict of interest.
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Maffi, P., Secchi, A. Islet Transplantation Alone Versus Solitary Pancreas Transplantation: an Outcome-Driven Choice?. Curr Diab Rep 19, 26 (2019). https://doi.org/10.1007/s11892-019-1145-2
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DOI: https://doi.org/10.1007/s11892-019-1145-2