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Necessities for a Clinical Islet Program

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Pancreatic Islet Isolation

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 938))

Abstract

For more than two decades we have been refining advances in islet cell transplantation as a clinical therapy for patients suffering from type 1 diabetes. A great deal of effort has gone to making this a viable therapy for a broader range of patients with type 1 diabetes. Clinical results have progressively improved, demonstrating clinical outcomes on par with other organ transplants, specifically in terms of insulin independence, graft and patient survival. We are now at the point where islet cell transplantation, in the form of allotransplantation, has become accepted as a clinical therapy in adult patients affected by type 1 diabetes, in particular those suffering from severe hypoglycaemic unawareness. This chapter provides an overview on how this has been undertaken over the years to provide outcomes on par with other organ transplantation results. In particular this chapter focuses on the processes and facilities that are required to establish a clinical islet isolation and transplantation program. It also outlines the very important underpinning processes of selection of the organ donor for islet isolation, the processes of organ donor operation and preservation of the pancreas by various means and the ideal ways to best improve outcomes for human islet cell isolation. Providing these more optimal conditions we can underpin the isolation processes to provide islets for transplantation and as such a safe, effective and feasible therapeutic option for an increasing number of patients suffering from type 1 diabetes with severe hypoglycaemic unawareness.

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Abbreviations

BMI:

Body mass index

CIT:

Cold ischaemic time

CMRL:

Connaught Medical Research Laboratories

CS:

Celsior

HTK:

Histidine-tryptophan-ketoglutarate

IEQ:

Islet cell isolation, islet equivalent

IEQ/g:

Islet equivalents per gram

MTC:

Mixed treatment comparison

QALY:

Quality-adjusted life years

SPK:

Simultaneous pancreas and kidney

T1D :

Type 1 diabetes

UW:

University of Wisconsin solution

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Authors and Affiliations

  1. National Pancreas and Islet Transplant Laboratories, The Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia

    Wayne J. Hawthorne

  2. Department of Surgery, Westmead Clinical School, Westmead Hospital, University of Sydney, Westmead, NSW, 2145, Australia

    Wayne J. Hawthorne

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  1. Wayne J. Hawthorne
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Correspondence to Wayne J. Hawthorne .

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Editors and Affiliations

  1. Laboratory of Cell Therapy of Diabetes, Department of Pediatrics, Faculty of Medicine and Odontology, Hospital Cruces, University of the Basque Country (UPV/EHU), Leioa, Spain

    Miriam Ramírez-Domínguez

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Hawthorne, W.J. (2016). Necessities for a Clinical Islet Program. In: Ramírez-Domínguez, M. (eds) Pancreatic Islet Isolation. Advances in Experimental Medicine and Biology, vol 938. Springer, Cham. https://doi.org/10.1007/978-3-319-39824-2_6

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