The clinical impact of islet transplantation

Islet cell transplantation has recently emerged as one
of the most promising therapeutic approaches to improving
glycometabolic control in diabetic patients
and, in many cases, achieving insulin independence.
Unfortunately, many persistent flaws still prevent islet
transplantation from becoming the gold standard
treatment for type 1 diabetic patients. We review the
state of the art of islet transplantation, outcomes, immunosuppression
and—most important—the impact
on patients’ survival and long-term diabetic complications
and eventual alternative options. Finally, we
review the many problems in the field and the challenges
to islet survival after transplantation. The rate
of insulin independence 1 year after islet cell transplantation
has significantly improved in recent years
(60% at 1 year posttransplantation compared with 15%
previously). Recent data indicate that restoration of
insulin secretion after islet cell transplantation is associated
with an improvement in quality of life, with
a reduction in hypoglycemic episodes and potentially
with a reduction in long-term diabetic complications.
Once clinical islet transplantation has been successfully
established, this treatment could even be offered
to diabetic patients long before the onset of diabetic
complications.