Transplantation of islets of limited use in type 1 diabetes
Islet transplantation is only for terminal patients in end-stage type 1 diabetes who have not responded to conventional therapy is appropriate. A study published in Diabetes Care, concluded that the risk of complications associated with transplantation, should be seen as a last resort. The authors examined the allograft in six patients aged 39 to 63 years with type 1 diabetes accompanied by severe hypoglycemia unawareness. Two patients received an allogeneic transplant of islet cells from cadaver donors, and four each received two.Two suffered fatal complications of the process of partial thrombosis of the portal vein and intra-abdominal bleeding. Immunosuppression resulted in two cases of severe neutropenia, three cases of renal failure, and one case of interstitial
pneumonitis. The auhors say islet transplantation for patients with severe metabolic instability despite compliance with treatment should be reserved for optimized with diabetes the most common dietary guidelines, blood sugar and insulin delivery systems.Reference: Hirshberg B et al (2003) the benefits and risks of solitary islet transplantation for type 1 diabetes using steroid immunosuppression: The National Institutes of Health experience Diabetes Care 26 (12) 3288-3295