Pancreas and islet transplantation in the treatment of type I diabetes

Abstract

Diabetes mellitus is a growing worldwide health problem, often leading to medical and psychosocial disasters such as blindness, amputations, coronary artery disease, stroke and kidney failure. Although the possibilities of treating insulin-dependent diabetic (IDDM) patients are numerous and sophisticated, none is able to normalize glucose metabolism and to prevent secondary diabetic complications. Consequently, replacement of functional pancreatic beta cells, via pancreas or islet transplantation, remains an attractive alternative to insulin therapy for patients with IDDM. Despite obvious benefits in terms of metabolic control, neither pancreas nor islet transplantation has achieved the widespread acceptance of other types of organ transplantation. Pancreas transplantation has not been more accepted because this procedure has caused some patient morbidity and health-care expense; on the other hand, pancreatic islet transplantation, which is less costly and technically less complex, has not yet achieved widespread and long-term clinical success.