Β‐Cell and renal transplantation options for diabetes. Issue 4 (18th December 2019)

• Record Type: Journal Article
• Authors: Flatt, A. J. S.; Bennett, D.; Counter, C.; Brown, A. L.; White, S. A.; Shaw, J. A. M.
• Is Part Of: Diabetic medicine. Volume 37:Issue 4(2020)
• Page Start: 580
• Page End: 592
• Publication Date: 2019-12-18
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.14177
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Despite major advances in structured education, insulin delivery and glucose monitoring, diabetes self‐management remains an unremitting challenge. Insulin therapy is inextricably linked to risk of dangerous hypoglycaemia and sustained hyperglycaemia remains a leading cause of renal failure. This review sets out to demystify transplantation for diabetes multidisciplinary teams, facilitating consideration and incorporation within holistic overall person‐centred management. Deceased and living donor kidney, whole pancreas and isolated islet transplant procedures, indications and potential benefits are described, in addition to outcomes within the integrated UK transplant programme. What's new?: Kidney transplantation for those with diabetes and end‐stage renal failure dramatically reduces mortality compared with dialysis. Best long‐term survival is achieved following simultaneous pancreas kidney transplantation or live donor kidney transplant. Islet transplantation can prevent recurrent life‐threatening hypoglycaemia and restore optimal overall glucose control in type 1 diabetes. This review is targeted at the diabetes multidisciplinary team to instil confidence in supporting early access to transplantation and providing well‐informed ongoing care for all suitable recipients. The international evidence base is reviewed and comparative UK outcome data for all renal and β‐cell replacement modalities are provided.