Islet (cell) transplantation for type 1 diabetes mellitus

Functional results of islet (cell) transplantation have continuously improved since the first clinical application. The main indication for islet (cell) transplantation is given for patients with type 1 diabetes without significant endogenous insulin secretion and frequent severe hypoglycemic episodes and principally in patients with end-stage nephropathy or previous kidney transplantation. In the majority of cases islet (cell) transplantation achieves the primary therapy goal of graft function and stable glucose control without severe hypoglycemia. According to registry data islet (cell) graft survival after 1 and 3 years is 82% and 75% and insulin independence 50% and 35%, respectively. This is associated with a significant improvement in quality of life and reduced progression of secondary diabetic microvascular complications compared with intensified insulin therapy alone. Patients with type 1 diabetes mellitus and indication for transplantation should be offered either islet (cell) or vascularized pancreas transplantation taking the individual benefits and risks of each treatment option into consideration.