Islet Transplantation for Diabetes Examined
(Ivanhoe Newswire) -- In the latest issue of the New England Journal of Medicine, researcher R. Paul Robertson, M.D., examines the progress of islet transplantation as a treatment for diabetes and offers suggestions for improvement based on current research.
He writes, "The good news is that rates of successful islet transplantation are increasing, and each success is teaching us valuable lessons about improving beta-cell replacement in patients with diabetes."
One of Dr. Robertson's suggestions concerns the site of islet infusion. Though the liver, spleen, kidney capsule, testes, brain and other sites have been considered as potential locations for islet infusion, Dr. Robertson found the liver is by far the most commonly used site because of early successes. Due to several clinical complications shown using the liver, he suggests using the peritoneal cavity and omentum, both in the intestine area of the stomach. These sites have been used successfully in animal models and shown to be safe for humans.
Dr. Robertson concludes many other important problems must be solved before islet transplantation can become a conventional therapeutic option. These include huge losses of islets during the isolation and purification processes, adverse reactions to immunosuppressive drugs, and insufficient supply. "The demand for islet transplantation far exceeds the number of islets available," Dr. Robertson writes. In addition, there is no research that has firm conclusions about who should receive this therapy.
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SOURCE: New England Journal of Medicine, 2004;350:694
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