Β Cell Replacement Therapy: The Next 10 Years. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Schuetz, Christian; Anazawa, Takayuki; Cross, Sarah E.; Labriola, Leticia; Meier, Raphael P.H.; Redfield, Robert R.; Scholz, Hanne; Stock, Peter G.; Zammit, Nathan W.
• Is Part Of: Transplantation. Volume 102:Issue 2(2018)
• Publication Date: 2018-02
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000001937
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Abstract: β cell replacement with either pancreas or islet transplantation has progressed immensely over the last decades with current 1- and 5-year insulin independence rates of approximately 85% and 50%, respectively. Recent advances are largely attributed to improvements in immunosuppressive regimen, donor selection, and surgical technique. However, both strategies are compromised by a scarce donor source. Xenotransplantation offers a potential solution by providing a theoretically unlimited supply of islets, but clinical application has been limited by concerns for a potent immune response against xenogeneic tissue. β cell clusters derived from embryonic or induced pluripotent stem cells represent another promising unlimited source of insulin producing cells, but clinical application is pending further advances in the function of the β cell like clusters. Exciting developments and rapid progress in all areas of β cell replacement prompted a lively debate by members of the young investigator committee of the International Pancreas and Islet Transplant Association at the 15th International Pancreas and Islet Transplant Association Congress in Melbourne and at the 26th international congress of The Transplant Society in Hong Kong. This international group of young investigators debated which modality of β cell replacement would predominate the landscape in 10 years, and their arguments are summarized here. Abstract : Rapid progress is expected in the areas of xenogeneic islet transplantation, stem cell derived β cells or other emerging β cell sources for the selected high-risk patients with T1DM. Will these sources ultimately replace the limited sources of adult human tissue, such as whole pancreas and islet?