Title

Is Islet Transplantation a Realistic Therapy for the Treatment of Type 1 Diabetes in the Near Future?

Document Type

Article

Publication Date

4-2001

Abstract

Shapiro and colleagues recently reported a 100% cure rate for type 1 diabetes with their “Edmonton protocol” for islet transplantation. This unprecedented success has caused a groundswell of enthusiasm and an unparalleled effort to replicate their experience. It has also raised questions about the clinical reality of this therapy and sparked a dialog about which patients should benefit from receiving this scarce allocated resource. This article reviews the factors contributing to the Edmonton success and obstacles to immediate and long-term expansion of islet transplantation. The authors argue that use of the two-layered method of pancreas preservation will enable the Edmonton protocol to cure diabetes from single and marginal cadaveric donors. A concerted effort will be required to expedite routing of pancreases to islet processing centers and transplant programs. The long-term success and expansion of islet transplantation will depend on not only safer forms of immunosuppression, but also new sources of islet tissue.

DOI

10.2337/diaclin.19.2.51