Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory

Abstract

Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with "brittle T1DM" , who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and hypoglycemic perception. The Edmonton group demonstrated that most patients who received islet infusions from more than one donor and were treated with steroid-free immunosuppressive drugs displayed a considerable decline in the initial insulin independence rates at eight years following the transplantation, but showed permanent C-peptide secretion, which facilitated glycemic control and protected patients against hypoglycemic episodes. Recently, data published by the Collaborative Islet Transplant Registry (CITR) has revealed that approximately 50% of the patients who undergo islet transplantation are insulin independent after a 3-year follow-up. Therefore, islet transplantation is able to successfully decrease plasma glucose and HbA1c levels, the occurrence of severe hypoglycemia, and improve patient quality of life. The goal of this paper was to review the human islet isolation and transplantation processes, and to describe the establishment of a human islet isolation laboratory at the Endocrine Division of the Hospital de Clínicas de Porto Alegre -Rio Grande do Sul, Brazil. Arch Endocrinol Metab. 2015;59(2):161-70

Effect of co-culture of mesenchymal stem/stromal cells with pancreatic islets on viability and function outcomes: a systematic review and meta-analysis

“…Successful islet transplantation is not only dependent on the number of transplanted islets, but also on their quality. 11,48 Thus, a strategy for preserving isolated islets without reducing their viability or function during culture period could be invaluable. 30 In this context, several studies have suggested that co-culture of islets with MSCs can enhance b cell viability and function and, consequently, islet graft survival.…”

Use of additives, scaffolds and extracellular matrix components for improvement of human pancreatic islet outcomes in vitro: A systematic review

“…Pancreatic islet transplantation is an established treatment for patients with type 1 diabetes mellitus (T1DM) that suffer from hypoglycemia unawareness with frequent episodes of hypoglycemia and marked glycemic lability. [1][2][3][4][5] A publication from The Collaborative Islet Transplant Registry (CITR) in 2012 showed a clear improvement in islet transplantation outcomes in the recent era. Insulin independence, 3 y after transplantation, improved from 27% in 1999-2002 (n D 214) to 37% in 2003-2006 (n D 255) and to 44% in the most recent period, 2007-2010 (n D 208).…”

Transplantation technologies for treatment of carbohydrate metabolism disorders

“…Оценка на мышиной модели обладает самой высокой корреляцией с клиническим эффектом ТОК, но занимает много времени и в настоящее время почти не применяется. Стерильность устанавливают с помощью тестов на наличие аэробных и анаэробных бактериальных культур, а также на микоплазму и эндотоксин [23]. Согласно классическому эдмонтонскому протоколу, введение изолята выполнялось немедленно после приготовления.…”