Islet transplantation in type I diabetes mellitus

Islet transplantation has become an established treatment option for a selected, small number of patients with type 1 diabetes mellitus. Indication, options, and long-term results of islet transplantation are presented. A compilation of original work on short- and long-term results after islet transplantation is reviewed. With islet transplantation, results regarding glucose control (HbA1c), reduction of hypoglycemia, and preservation of function of the transplanted kidney are comparable to pancreas transplantation. While long-term insulin independence is not achieved in most cases despite multiple transplantations, the occurrence of transplantation-associated complications is much lower compared to pancreas transplantation. For patients with poor glycemic control and recurrent severe hypoglycemia, and for patients with a planned kidney transplantation, islet or pancreas transplantation should be evaluated. The former is the preferred option for patients with a high perioperative risk.