Abstract
Despite modern medical breakthroughs, diabetes mellitus is a worldwide leading cause
of morbidity and mortality. Definitive surgical treatment of diabetes mellitus was
established with the advent and refinement of clinical pancreas transplantation in
the 1960s. During the following decades, critical discoveries involving islet isolation
and engraftment took place. Clinical islet cell transplantation represents the potential
for reduced insulin requirements and debilitating hypoglycemic episodes without the
morbidity of surgery. Unfortunately, islet cell transplantation was unable to achieve
comparable results with solid organ transplantation. This was until the Edmonton protocol
(steroid-free immunosuppression) was described, which demonstrated that islet cell
transplantation could be a viable alternative to pancreas transplantation. Significant
advances in islet purification techniques and novel immunomodulatory agents have since
renewed interest in islet cell transplantation. Yet the field is still challenged
by a limited supply of islet cells, inadequate engraftment, and the deleterious effects
of chronic immunosuppression. This article discusses the history and the current status
of clinical islet cell transplantation.
Keywords
Islet cell transplantation - Type 1 diabetes - β cells
