Beta-Cell Replacement via Transplantation in Type 1 Diabetes Mellitus
Type 1 diabetes mellitus involves loss of pancreatic beta-cell function. In individuals where conventional glycemic management is insufficient to achieve treatment targets, a beta-cell replacement strategy through surgical transplantation represents a defined clinical pathway with specific indications and eligibility criteria.
The protocol addresses beta-cell replacement therapy — a transplantation-based intervention — as a means of restoring endogenous insulin secretion in eligible individuals with type 1 diabetes mellitus. The specific approach and eligibility criteria are detailed in the complete protocol.
Near-normal glycemic levels with HbA1c <7.0% (<53 mmol/mol) and reliable prevention of problematic hypoglycemia.
References
DOI: 10.2337/dci21-0043
- Whole organ pancreas and pancreatic islet transplantation are currently the only means of clinical b-cell replacement (Fig. 7).
- Islet transplantation, a less invasive procedure, is indicated in people with excessive glycemic lability and frequent level 3 hypoglycemia despite optimal medical therapy, and allows for inclusion of older people and those with coronary artery disease who would not be eligible for a whole-pancreas transplant.
- Most whole-pancreas transplants are performed simultaneously with a kidney transplant (simultaneous pancreas and kidney [SPK] transplant).
- Regardless of the b-cell replacement approach (pancreas or islets), the majority of recipients experience reliable prevention of problematic hypoglycemia with near-normal glycemic levels.