期刊
NATURE REVIEWS ENDOCRINOLOGY
卷 13, 期 5, 页码 268-277出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/nrendo.2016.178
关键词
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资金
- NIH Clinical Islet Transplant (CIT) Consortium
- National Institutes of Allergy, Immunology and Infectious Disease (NIAID)
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Diabetes Research Institute Foundation (DRIF)
- Juvenile Diabetes Research Foundation (JDRF)
- Alberta Health Services
- Government of Alberta
- Diabetes Research Institute Foundation of Canada (DRIFCan)
- DRIF
- JDRF
- Leona M. and Harry B. Helmsley Charitable Trust
- National Science Center, Poland
- National Center of Science and Development, Poland
- Alberta Innovates [201201154] Funding Source: researchfish
Clinical pancreatic islet transplantation can be considered one of the safest and least invasive transplant procedures. Remarkable progress has occurred in both the technical aspects of islet cell processing and the outcomes of clinical islet transplantation. With > 1,500 patients treated since 2000, this therapeutic strategy has moved from a curiosity to a realistic treatment option for selected patients with type 1 diabetes mellitus (that is, those with hypoglycaemia unawareness, severe hypoglycaemic episodes and glycaemic lability). This Review outlines the techniques required for human islet isolation, in vitro culture before the transplant and clinical islet transplantation, and discusses indications, optimization of recipient immunosuppression and management of adjunctive immunomodulatory and anti-inflammatory strategies. The potential risks, long-term outcomes and advances in treatment after the transplant are also discussed to further move this treatment towards becoming a more widely available option for patients with type 1 diabetes mellitus and eventually a potential cure.
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