Chapter 39 - Living donors

Abstract

Recent improvements in outcomes of islet transplantation can be attributed to the advancement of islet isolation techniques and introduction of effective immunosuppressive therapies. However, a disadvantage of islet transplantation is that multiple transplants may be required to achieve insulin independence, thus requiring more donors. The shortage of donors is a hindrance to the development of islet transplantation, and living donors have been suggested as an alternative source. With the use of partial pancreas from living donors in islet transplantation, cold ischemia time is short and highly potent islets can be isolated. Moreover, feasibility of “on demand” transplant may be beneficial to recipients, which can enable early initiation of immunosuppressive therapy. Living donor islet transplantation can be considered a solution to donor shortage by improving the long-term outcomes of islet transplantation, however, the safety and ethical aspects of using living donors are of concern and long-term risks need to be minimized.