Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations

Jacob A Tatum,* Max O Meneveau,* Kenneth L Brayman Department of Surgery, Division of Transplantation, The University of Virginia Health System, Charlottesville, VA, USA *These authors contributed equally to this work. Abstract: Type 1 diabetes mellitus is an autoimmune disorder of...

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Autores principales:	Tatum JA, Meneveau MO, Brayman KL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Islet transplantation Diabetes Mellitus Type 1 Brittle Diabetes Single Donor Patient Selection Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/0dfc8830ba7240df8ddca7d4e7b472fd
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spelling	oai:doaj.org-article:0dfc8830ba7240df8ddca7d4e7b472fd2021-12-02T07:20:09ZSingle-donor islet transplantation in type 1 diabetes: patient selection and special considerations1178-7007https://doaj.org/article/0dfc8830ba7240df8ddca7d4e7b472fd2017-02-01T00:00:00Zhttps://www.dovepress.com/single-donor-islet-transplantation-in-type-1-diabetes-patient-selectio-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Jacob A Tatum,* Max O Meneveau,* Kenneth L Brayman Department of Surgery, Division of Transplantation, The University of Virginia Health System, Charlottesville, VA, USA *These authors contributed equally to this work. Abstract: Type 1 diabetes mellitus is an autoimmune disorder of the endocrine pancreas that currently affects millions of people in the United States. Although the disease can be managed with exogenous insulin administration, the ultimate cure for the condition lies in restoring a patient’s ability to produce their own insulin. Islet cell allotransplantation provides a means of endogenous insulin production. Though far from perfected, islet transplants are now a proven treatment for type 1 diabetics. However, proper patient selection is critical for achieving optimal outcomes. Given the shortage of transplantable organs, selecting appropriate candidates for whom the procedure will be of greatest benefit is essential. Although many of those who receive islets do not retain insulin independence, grafts do play a significant role in preventing hypoglycemic episodes that can be quite detrimental to quality of life and potentially fatal. Additionally, islet transplant requires lifelong immunosuppression. Antibodies, both preformed and following islet infusion, may play important roles in graft outcomes. Finally, no procedure is without inherent risk and islet transfusions can have serious consequences for recipients’ livers in the form of both vascular and metabolic complications. Therefore, patient-specific factors that should be taken into account before islet transplantation include aims of therapy, sensitization, and potential increased risk for hepatic and portal-venous sequelae. Keywords: islet transplantation, diabetes mellitus type 1, brittle diabetes, single donor, patientTatum JAMeneveau MOBrayman KLDove Medical PressarticleIslet transplantationDiabetes Mellitus Type 1Brittle DiabetesSingle DonorPatient SelectionSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 10, Pp 73-78 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Islet transplantation Diabetes Mellitus Type 1 Brittle Diabetes Single Donor Patient Selection Specialties of internal medicine RC581-951
spellingShingle	Islet transplantation Diabetes Mellitus Type 1 Brittle Diabetes Single Donor Patient Selection Specialties of internal medicine RC581-951 Tatum JA Meneveau MO Brayman KL Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations
description	Jacob A Tatum,* Max O Meneveau,* Kenneth L Brayman Department of Surgery, Division of Transplantation, The University of Virginia Health System, Charlottesville, VA, USA *These authors contributed equally to this work. Abstract: Type 1 diabetes mellitus is an autoimmune disorder of the endocrine pancreas that currently affects millions of people in the United States. Although the disease can be managed with exogenous insulin administration, the ultimate cure for the condition lies in restoring a patient’s ability to produce their own insulin. Islet cell allotransplantation provides a means of endogenous insulin production. Though far from perfected, islet transplants are now a proven treatment for type 1 diabetics. However, proper patient selection is critical for achieving optimal outcomes. Given the shortage of transplantable organs, selecting appropriate candidates for whom the procedure will be of greatest benefit is essential. Although many of those who receive islets do not retain insulin independence, grafts do play a significant role in preventing hypoglycemic episodes that can be quite detrimental to quality of life and potentially fatal. Additionally, islet transplant requires lifelong immunosuppression. Antibodies, both preformed and following islet infusion, may play important roles in graft outcomes. Finally, no procedure is without inherent risk and islet transfusions can have serious consequences for recipients’ livers in the form of both vascular and metabolic complications. Therefore, patient-specific factors that should be taken into account before islet transplantation include aims of therapy, sensitization, and potential increased risk for hepatic and portal-venous sequelae. Keywords: islet transplantation, diabetes mellitus type 1, brittle diabetes, single donor, patient
format	article
author	Tatum JA Meneveau MO Brayman KL
author_facet	Tatum JA Meneveau MO Brayman KL
author_sort	Tatum JA
title	Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations
title_short	Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations
title_full	Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations
title_fullStr	Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations
title_full_unstemmed	Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations
title_sort	single-donor islet transplantation in type 1 diabetes: patient selection and special considerations
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/0dfc8830ba7240df8ddca7d4e7b472fd
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Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations

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