Towards the fabrication of a 3D printed vascularized islet transplantation device for the treatment of type 1 diabetes

Clinical islet transplantation was first realized over four decades ago at the University of Minnesota. Autologous islet transplantation is now widely recognized as a treatment to prevent diabetes in patients after pancreas excision and is offered at major transplant centers throughout the United States and the world. Type 1 diabetes represents a much larger demographic in which islet transplantation may benefit patients. Allogeneic islet transplantation can now offer similar outcomes to pancreas transplantation in a subset of patients with labile type 1 diabetes with less risk than whole organ transplantation. It is recognized as a standard of care in nations around the world but not in the United States, despite the important developmental role US scientists and physicians have played. Early reports of islet transplantation focused on insulin independence that proved to diminish over time. However, regardless of insulin status, islet transplantation provides benefits ranging from improved quality of life to reduction in diabetic complications. A National Institutes of Health sponsored multi-center Phase 3 Clinical Trial (CIT-07) demonstrated safety and efficacy, although the Food and Drug Administration chose to consider islets as a biologic that requires licensure, which makes offering the procedure in the clinic very challenging. Until regulations can be brought into communion with international standards, allogeneic islet transplantation in the United States is unlikely to match international levels of success and once promising programs are left to wither on the vine. Food and Drug Administration approval would open the door for third party medical reimbursement and allow many patients the opportunity to enjoy better health and quality of life. Establishment of clinical islet transplantation for type 1 diabetes would lead to optimizations in procedures making it more efficacious and cost effective while offering support for ongoing islet xenotransplantation studies that could bring islet transplantation to even more patients.

Download Full-text

Mortality in People With Type 1 Diabetes, Severe Hypoglycemia, and Impaired Awareness of Hypoglycemia Referred for Islet Transplantation

Transplantation Direct ◽

10.1097/txd.0000000000000841 ◽

2018 ◽

Vol 4 (11) ◽

pp. e401 ◽

Cited By ~ 4

Author(s):

Melissa H. Lee ◽

Glenn M. Ward ◽

Richard J. MacIsaac ◽

Kathy Howe ◽

D. Jane Holmes-Walker ◽

...

Keyword(s):

Type 1 Diabetes ◽

Islet Transplantation ◽

Severe Hypoglycemia ◽

Impaired Awareness

Download Full-text

Clinical islet transplantation in type 1 diabetes mellitus: results of Australia's first trial

The Medical Journal of Australia ◽

10.5694/j.1326-5377.2006.tb00206.x ◽

2006 ◽

Vol 184 (5) ◽

pp. 221-225 ◽

Cited By ~ 52

Author(s):

Philip J O’Connell ◽

Wayne J Hawthorne ◽

Brian J Nankivell ◽

Anita T Patel ◽

Stacey N Walters ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Islet Transplantation ◽

Clinical Islet Transplantation

Download Full-text

THERAPY OF ENDOCRINE DISEASE: Islet transplantation for type 1 diabetes: so close and yet so far away

Acta Endocrinologica ◽

10.1530/eje-15-0094 ◽

2015 ◽

Vol 173 (5) ◽

pp. R165-R183 ◽

Cited By ~ 21

Author(s):

Mohsen Khosravi-Maharlooei ◽

Ensiyeh Hajizadeh-Saffar ◽

Yaser Tahamtani ◽

Mohsen Basiri ◽

Leila Montazeri ◽

...

Keyword(s):

Type 1 Diabetes ◽

Islet Transplantation ◽

Diabetic Patients ◽

Immune Rejection ◽

Pancreatic Islet Transplantation ◽

Insulin Independence ◽

Endocrine Disease ◽

The Past ◽

Source Limitation

Over the past decades, tremendous efforts have been made to establish pancreatic islet transplantation as a standard therapy for type 1 diabetes. Recent advances in islet transplantation have resulted in steady improvements in the 5-year insulin independence rates for diabetic patients. Here we review the key challenges encountered in the islet transplantation field which include islet source limitation, sub-optimal engraftment of islets, lack of oxygen and blood supply for transplanted islets, and immune rejection of islets. Additionally, we discuss possible solutions for these challenges.

Download Full-text

Islet transplantation for Type 1 diabetes: where are we now?

Expert Review of Clinical Immunology ◽

10.1586/1744666x.2015.978291 ◽

2014 ◽

Vol 11 (1) ◽

pp. 59-68 ◽

Cited By ~ 28

Author(s):

Aaron J Ahearn ◽

Justin R Parekh ◽

Andrew M Posselt

Keyword(s):

Type 1 Diabetes ◽

Islet Transplantation

Download Full-text

Effect of Exenatide on ?? Cell Function After Islet Transplantation in Type 1 Diabetes

Transplantation Journal ◽

10.1097/01.tp.0000251379.46596.2d ◽

2007 ◽

Vol 83 (1) ◽

pp. 24-28 ◽

Cited By ~ 101

Author(s):

Khalid Al Ghofaili ◽

Michelle Fung ◽

Ziliang Ao ◽

Mark Meloche ◽

R Jean Shapiro ◽

...

Keyword(s):

Type 1 Diabetes ◽

Islet Transplantation ◽

Cell Function

Download Full-text

Eligibility of patients with type 1 diabetes for islet transplantation alone

Transplantation, Bioengineering, and Regeneration of the Endocrine Pancreas ◽

10.1016/b978-0-12-814833-4.00033-2 ◽

2020 ◽

pp. 407-416

Author(s):

Thierry Berney ◽

Mohamed Alibashe-Ahmed ◽

Giacomo Gastaldi ◽

Axel Andres

Keyword(s):

Type 1 Diabetes ◽

Islet Transplantation

Download Full-text

Knowledge and Demand for Information about Islet Transplantation in Patients with Type 1 Diabetes

Journal of Transplantation ◽

10.1155/2011/136298 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Yuko Yamamoto ◽

Masakazu Nishigaki ◽

Naoko Kato ◽

Michio Hayashi ◽

Teruo Shiba ◽

...

Keyword(s):

Type 1 Diabetes ◽

Islet Transplantation ◽

Cross Sectional Study ◽

Sources Of Information ◽

Related Factors ◽

Cross Sectional ◽

Self Monitoring ◽

High Level ◽

Source Of Information

This cross-sectional study based on self-administrated questionnaire was conducted to investigate knowledge, related factors, and sources of information regarding islet transplantation in patients with type 1 diabetes in Japan. Among 137 patients who provided valid responses, 67 (48.9%) knew about islet transplantation. Their main source of information was newspapers or magazines (56.7%) and television or radio (46.3%). However, 85.8% of patients preferred the attending physician as their source of information. Although more than half of the patients were correctly aware of issues related to islet transplantation, the following specific issues for islet transplantation were not understood or considered, and there was little knowledge of them: need for immunosuppressants, lifestyle and dietary adaptations, fewer bodily burdens, and complications. The experience of hypoglycaemia, a high level of academic background, frequent self-monitoring of blood glucose, and the use of continuous subcutaneous insulin infusion were related to higher knowledge about islet transplantation.

Download Full-text