Cargando…

Who Should Be Considered for Islet Transplantation Alone?

PURPOSE OF REVIEW: Episodic hypoglycemia is an almost inevitable consequence of exogenous insulin treatment of type 1 diabetes, and in up to 30% of patients, this can lead to impaired awareness of hypoglycemia. This predisposes to recurrent severe hypoglycemia and has a huge impact on quality of lif...

Descripción completa

Detalles Bibliográficos
Autores principales: Othonos, Nantia, Choudhary, Pratik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350263/
https://www.ncbi.nlm.nih.gov/pubmed/28293906
http://dx.doi.org/10.1007/s11892-017-0847-6
_version_ 1782514623476400128
author Othonos, Nantia
Choudhary, Pratik
author_facet Othonos, Nantia
Choudhary, Pratik
author_sort Othonos, Nantia
collection PubMed
description PURPOSE OF REVIEW: Episodic hypoglycemia is an almost inevitable consequence of exogenous insulin treatment of type 1 diabetes, and in up to 30% of patients, this can lead to impaired awareness of hypoglycemia. This predisposes to recurrent severe hypoglycemia and has a huge impact on quality of life. Although many patients can get resolution of severe hypoglycemia through novel education and technology, some patients continue to have ongoing life-threatening hypoglycemia. Islet transplantation offers an alternative therapeutic option for these patients, in whom these conventional approaches have been unsuccessful. This review discusses the selection process of identifying suitable candidates based on recent clinical data. RECENT FINDINGS: Results from studies of islet transplantation suggest the optimal recipient characteristics for successful islet transplantation include age >35 years, insulin requirements <1.0/kg, and weight >85 kg. SUMMARY: Islet transplantation can completely resolve hypoglycemia and near-normalize glucose levels, achieving insulin independence for a limited period of time in up to 40% of patients. The selection of appropriate candidates, optimizing donor selection, the use of an optimized protocol for islet cell extraction, and immunosuppression therapy have been proved to be the key criteria for a favorable outcome in islet transplantation.
format Online
Article
Text
id pubmed-5350263
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-53502632017-03-27 Who Should Be Considered for Islet Transplantation Alone? Othonos, Nantia Choudhary, Pratik Curr Diab Rep Immunology, Transplantation, and Regenerative Medicine (L Piemonti and V Sordi, Section Editors) PURPOSE OF REVIEW: Episodic hypoglycemia is an almost inevitable consequence of exogenous insulin treatment of type 1 diabetes, and in up to 30% of patients, this can lead to impaired awareness of hypoglycemia. This predisposes to recurrent severe hypoglycemia and has a huge impact on quality of life. Although many patients can get resolution of severe hypoglycemia through novel education and technology, some patients continue to have ongoing life-threatening hypoglycemia. Islet transplantation offers an alternative therapeutic option for these patients, in whom these conventional approaches have been unsuccessful. This review discusses the selection process of identifying suitable candidates based on recent clinical data. RECENT FINDINGS: Results from studies of islet transplantation suggest the optimal recipient characteristics for successful islet transplantation include age >35 years, insulin requirements <1.0/kg, and weight >85 kg. SUMMARY: Islet transplantation can completely resolve hypoglycemia and near-normalize glucose levels, achieving insulin independence for a limited period of time in up to 40% of patients. The selection of appropriate candidates, optimizing donor selection, the use of an optimized protocol for islet cell extraction, and immunosuppression therapy have been proved to be the key criteria for a favorable outcome in islet transplantation. Springer US 2017-03-14 2017 /pmc/articles/PMC5350263/ /pubmed/28293906 http://dx.doi.org/10.1007/s11892-017-0847-6 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Immunology, Transplantation, and Regenerative Medicine (L Piemonti and V Sordi, Section Editors)
Othonos, Nantia
Choudhary, Pratik
Who Should Be Considered for Islet Transplantation Alone?
title Who Should Be Considered for Islet Transplantation Alone?
title_full Who Should Be Considered for Islet Transplantation Alone?
title_fullStr Who Should Be Considered for Islet Transplantation Alone?
title_full_unstemmed Who Should Be Considered for Islet Transplantation Alone?
title_short Who Should Be Considered for Islet Transplantation Alone?
title_sort who should be considered for islet transplantation alone?
topic Immunology, Transplantation, and Regenerative Medicine (L Piemonti and V Sordi, Section Editors)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350263/
https://www.ncbi.nlm.nih.gov/pubmed/28293906
http://dx.doi.org/10.1007/s11892-017-0847-6
work_keys_str_mv AT othonosnantia whoshouldbeconsideredforislettransplantationalone
AT choudharypratik whoshouldbeconsideredforislettransplantationalone