Improved Metabolic Control and Quality of Life in Seven Patients With Type 1 Diabetes Following Islet After Kidney Transplantation

Abstract

Islet transplantation represents a feasible therapeutic option for patients with T1DM bearing a stable kidney allograft. Insulin independence at 1 year is lower than what reported in islet transplant alone. Nevertheless, clear benefits in terms of optimal metabolic control and absence of severe hypoglycemia are invariably present.

Bone Marrow-Derived Stem Cell Transplantation for the Treatment of Insulin-Dependent Diabetes

“…These advances are retained even when exogenous insulin is required after transplantation of an inadequate islet mass, or after graft dysfunction [2]. The metabolic effects are paralleled by a significant improvement in the pa-tients' quality of life [3][4][5][6][7][8]. Also, a positive impact of islet transplantation on the progression of diabetes complications has been reported.…”

β-Cell regeneration: the pancreatic intrinsic faculty

“…Today, insulin-dependent patients rely on daily insulin injections. Transplantation of isolated islets from cadavers is problematic due to donor scarcity (about 6000 islets/kg of body weight are required [13][14][15]), and is only applicable to certain forms of diabetes; in addition, transplantation has met with limited success due to restricted engraftment survival [16][17][18][19]. A promising approach relies on devising unlimited in vitro generation of insulin- Table 1.…”

Single-centre experience of extending indications for percutaneous intraportal islet autotransplantation (PIPIAT) after pancreatic surgery to prevent diabetes: feasibility, radiological aspects, complications and clinical outcome

“…Beyond the different purposes of allotransplantation and autotransplantation (cure vs prevention of diabetes), the common goal is to improve the patient quality of life, to reach insulin independence or to significantly reduce exogenous insulin requirement [23][24][25] and to prevent diabetes-related complications, such as nephropathy, retinopathy and neuropathy. 8,9,26 The recent increase in the number of PIPIAT can be correlated to the increase in the number of patients considered for major pancreatic surgery, a prerogative of high-volume medical centres, 27 and the early diagnosis of pre-malignant lesions because of the improvement of diagnostic tools.…”