Fiorina Paolo, Secchi Antonio
Transplantation Medicine, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
Endocrinol Metab Clin North Am. 2007 Dec;36(4):999-1013; ix. doi: 10.1016/j.ecl.2007.07.004.
Islet cell transplantation recently has emerged as one the most promising therapeutic approaches to improving glycometabolic control in type 1 diabetic patients, and, in many cases, to obtaining insulin independence. Islet cell transplantation requires a relatively short hospital stay and has the advantage of being a relatively noninvasive procedure. The rate of insulin independence 1 year after islet cell transplantation has improved significantly in recent years (60% at 1 year after transplantation compared to the 15% in the past years). Data from a recent international trial confirmed that islet cell transplantation potentially can be a cure for type 1 diabetes. Recent data indicate that insulin independence after islet cell transplantation is associated with an improvement in glucose metabolism and quality of life and with a reduction in hypoglycemic episodes. Islet cell transplantation is still in its initial stages, and many obstacles still need to be overcome. Once clinical islet transplantation has been established, this treatment could be offered to diabetic patients long before the onset of diabetic complications or to patients with life-threatening hypoglycemic unawareness and brittle diabetes.
胰岛细胞移植最近已成为改善1型糖尿病患者糖代谢控制、并且在许多情况下实现胰岛素自主的最有前景的治疗方法之一。胰岛细胞移植需要相对较短的住院时间,并且具有相对非侵入性手术的优势。近年来,胰岛细胞移植后1年的胰岛素自主率有了显著提高(移植后1年为60%,而过去几年为15%)。最近一项国际试验的数据证实,胰岛细胞移植有可能治愈1型糖尿病。最近的数据表明,胰岛细胞移植后的胰岛素自主与糖代谢和生活质量的改善以及低血糖发作的减少有关。胰岛细胞移植仍处于初始阶段,仍有许多障碍需要克服。一旦建立了临床胰岛移植,这种治疗可以在糖尿病并发症发生之前很久就提供给糖尿病患者,或者提供给有危及生命的低血糖无知觉和脆性糖尿病的患者。