Human Islet Transplantation: Current Status and Future Direction

James   J.   McGarrigle; Jose      Oberholzer

doi:10.2174/1876402911305030002

Abstract

Throughout the past four decades, many inroads have been made in islet transplantation, so much so that this treatment is now seen as a viable therapeutic option for an increasing number of Type 1 diabetic patients. Islet transplantation not only provides initial insulin independence for selected Type 1 diabetic patients but also delivers long-term graft function and symptomatic benefit in terms of avoidance of severe hypoglycemia. However, despite many recent successes in this therapy, research and development is needed to improve this procedure further, with the ultimate aim of providing long-term insulin independence without the requirement for immunosuppressive medication. There are still numerous hurdles that must be overcome to ensure the accomplishment of this goal. Such challenges include, but are not solely limited to, the inadequate supply of insulin producing cells, the inability to fully determine islet function prior to and following transplantation, and the resultant immune mediated rejection of donor islets post transplantation. Years after transplantation, some patients present with a yet to be understood steady decline in islet graft function. The future development of islet transplantation hinges on the ability to understand and overcome these obstacles. Micro and nano technologies are seen as playing a vital role in addressing these challenges for accomplishing the ultimate goal of offering a functional cure for diabetes.

Keywords: Biocompatibility, Diabetes, Immunosuppressant, Islet Transplantation, Microencapsulation, Microfluidics, Nanoparticles.

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