Abstract
A characteristic critical to the success of cell-based regenerative medicine approaches to treatment of disease is the ability of cells or tissue to engraft. Successful islet autotransplantation (IAT) following near-total or total pancreatectomy (TP) was the first clear proof that human islet tissue could engraft at an ectopic site and maintain insulin independence. This clinical observation holds promise for other regenerative medicine strategies aimed at treating diabetes. Follow-up observations have documented that if early insulin independence is achieved, then long-term function, 10 years or longer, is possible, indicating that intrahepatic β-cell residence is durable. Clinically, if pancreatectomy is to be done for benign diseases of the pancreas, IAT should accompany it, as the risks of surgical diabetes outweigh the risks of IAT. Surmounting the differences between IAT and allogeneic islet transplant may improve the therapeutic potential of cellular based replacement treatments for type 1 diabetes.
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