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Islet cell transplantation for the treatment of type 1 diabetes in the USA

  • Topics
  • HBP treatment using cell transplantation in the near future
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Islet cell transplantation (ICTx) is one of the most effective treatments for type 1 diabetes and is less invasive compared to whole organ transplantation. The US has been the leader in the research and clinical applications of ICTx for the last 40 years. ICTx requires complex procedures, including pancreas procurement and preservation; pancreas digestion; islet purification; and transplantation. Even with the dramatic progresses in each of the procedures listed above, there are still challenges to make ICTx the standard therapy. These challenges are: (1) obtaining enough islets from a single donor and (2) preventing graft loss due to allogenic rejection and recurrence of autoimmune islet destruction. A new preservation strategy for pancreata and pancreatic ducts using ET-Kyoto solution as well as a new islet purification method using iodixanol has substantially improved islet yields. Continuous research to improve the efficacy of islet isolation will solve the issue of obtaining enough islets from a single donor. Immunological tolerance is an ideal solution for the issue of rejection and autoimmune recurrence and a regulatory T cell strategy seems promising. Moreover, the SUITO index is a simple and powerful tool to assess engrafted islet mass and is, therefore, useful for evaluating the efficacy of new immunosuppressant strategies. Once ICTx becomes a standard treatment, the donor shortage will become the next challenge. Marginal or living donor islet transplantations could help alleviate this issue; however, bio-artificial islet transplantation with animal islets could be the ultimate solution.

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Acknowledgments

We thank Dr. Carson Harrod for his careful review of this manuscript. This research is partly funded by All Saints Health Foundation, Otsuka Pharmaceutical Factory Inc., and the Juvenile Diabetes Research Foundation.

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Authors and Affiliations

  1. Baylor Research Institute, Baylor Institute for Immunology Research, Dallas, TX, USA

    Tetsuya Ikemoto, Hirofumi Noguchi, Yasutaka Fujita & Shinichi Matsumoto

  2. Baylor University Medical Center, Dallas, TX, USA

    Masayuki Shimoda, Bashoo Naziruddin, Andrew Jackson, Yoshiko Tamura, Nicholas Onaca & Marlon F. Levy

  3. Institute of Biomedical Studies, Baylor University, Waco, TX, USA

    Andrew Jackson

  4. Baylor All Saints Islet Cell Laboratory, 1400 8th, Fort Worth, TX, 76104, USA

    Tetsuya Ikemoto, Hirofumi Noguchi, Yasutaka Fujita & Shinichi Matsumoto

Authors
  1. Tetsuya Ikemoto
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  2. Hirofumi Noguchi
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  3. Masayuki Shimoda
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Correspondence to Shinichi Matsumoto.

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Ikemoto, T., Noguchi, H., Shimoda, M. et al. Islet cell transplantation for the treatment of type 1 diabetes in the USA. J Hepatobiliary Pancreat Surg 16, 118–123 (2009). https://doi.org/10.1007/s00534-008-0019-9

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  • DOI: https://doi.org/10.1007/s00534-008-0019-9

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