Clinical Islet Transplant Program and Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Diabetes Metab Syndr Obes. 2014 Jun 23;7:211-23. doi: 10.2147/DMSO.S50789. eCollection 2014.
Islet transplantation is a well-established therapeutic treatment for a subset of patients with complicated type I diabetes mellitus. Prior to the Edmonton Protocol, only 9% of the 267 islet transplant recipients since 1999 were insulin independent for >1 year. In 2000, the Edmonton group reported the achievement of insulin independence in seven consecutive patients, which in a collaborative team effort propagated expansion of clinical islet transplantation centers worldwide in an effort to ameliorate the consequences of this disease. To date, clinical islet transplantation has established improved success with insulin independence rates up to 5 years post-transplant with minimal complications. In spite of marked clinical success, donor availability and selection, engraftment, and side effects of immunosuppression remain as existing obstacles to be addressed to further improve this therapy. Clinical trials to improve engraftment, the availability of insulin-producing cell sources, as well as alternative transplant sites are currently under investigation to expand treatment. With ongoing experimental and clinical studies, islet transplantation continues to be an exciting and attractive therapy to treat type I diabetes mellitus with the prospect of shifting from a treatment for some to a cure for all.
胰岛移植是治疗复杂 I 型糖尿病患者的一种成熟的治疗方法。在埃德蒙顿方案之前，自 1999 年以来，267 名胰岛移植受者中只有 9%的人在 >1 年内不需要胰岛素。2000 年，埃德蒙顿小组报告称，7 名连续患者实现了胰岛素独立性，这一合作团队的努力推动了全球临床胰岛移植中心的扩张，以努力改善这种疾病的后果。迄今为止，临床胰岛移植在移植后 5 年内取得了更高的胰岛素独立性成功率，同时并发症最小。尽管取得了显著的临床成功，但供体的可用性和选择、移植物的植入和免疫抑制的副作用仍然是需要解决的现有障碍，以进一步改善这种治疗方法。目前正在进行临床试验，以改善移植物的植入、胰岛素分泌细胞来源的可用性以及替代移植部位，以扩大治疗范围。随着正在进行的实验和临床研究，胰岛移植继续成为治疗 I 型糖尿病的一种令人兴奋和有吸引力的治疗方法，有望从一些患者的治疗方法转变为所有患者的治疗方法。
