Abstract
Islet transplantation can be an important ther-apeutic option for adults with unstable type 1 diabetes-individuals who, despite their best efforts, have wide, unpredictable fluctuations in blood sugar levels or who are no longer able to sense that their blood sugar is dangerously low. For these people, transplantation may be a viable solution. Since the first report of successful pancreatic islet transplantation to reverse hyperglycaemia in diabetic rodents, there has been great interest in determining the optimal site for implantation. Although the portal vein remains the most frequently used site clinically, it is not ideal. About half of the islets introduced into the liver die during or shortly after transplantation. Complications associated with intraportal islet injection and the progressive functional decline of intrahepatic islets encourage the exploration of alternative sites. In tests in animals, scientists from the Diabetes Re-search Institute in Milan showed that bone marrow is a promising alternative site for islet transplantation. This review considers bone marrow as site of islet transplantation and metabolic, immunological and technical aspects are discussed.
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