Pancreas and islet cell transplantation in diabetes.

PURPOSE OF REVIEW: The following review of the field of whole organ pancreas and islet cell transplantation for type 1 diabetes mellitus is timely and relevant, since new findings and outcomes in both fields have emerged in the recent past.

RECENT FINDINGS: Research in the field of whole organ pancreas transplantation is characterized by small advances in knowledge in an established, but not widely used procedure. For islet transplantation, the field is evolving more rapidly. Disappointing clinical trial results, however, have hampered enthusiasm for this procedure. Islet transplantation research recently has focused on delineating possible causes of failure to achieve or sustain insulin independence and innovations to address both this failure and the current shortage of islets for clinical transplantation. Pancreas transplantation research is less innovative at this point, focusing mainly on optimizing clinical results.

SUMMARY: These published findings suggest that at the present time, clinical application of islet transplantation should be limited to clinical trials, focusing on techniques to enhance islet engraftment and survival. Whole organ pancreas transplantation remains the preferable transplant option for the type one diabetic patient.