Beta cell replacement through transplantation remains the only treatment option for Type 1 diabetes enabling restoration of near-physiological glucose levels without significant hypoglycemia. Outlining the most recent advances and research breakthroughs, this practical guide and reference work explores the impact of islet cell transplantation and brings together leading multidisciplinary proponents critical to future success in the field. Edited by a surgeon and an endocrinologist at the forefront of the technology, this volume considers challenges associated with this procedure including lack of sufficient donor organs and the side effects of immunosuppressive therapy, as well as the potential benefits for current and future patients.
Islet Transplantation and Beta Cell Replacement Therapy, after a brief historical overview, examines:
- the key role of endocrinologists in holistic assessment and selection of islet transplant recipients
- the factors underlying attrition of islet function over time and need for enhanced graft monitoring post transplantation
- future in vivo islet imaging
- setting up new clinical islet transplant programs by outlining potential models and pitfalls-including cost effectiveness and sustainable integrated approaches
- clinical outcomes and the future direction for islet transplantation, including alternative sources of beta cells, to meet future clinical needs through xenotransplantation, new insulin-producing cells from adult tissue, and stem cell banks
Table of Contents
A Historical Perspective on Experimental and Clinical Islet Transplantation. Hypoglycemia in Type 1 Diabetes: The Need for a New Approach. Patient Selection and Assessment: An Endocrinologist's Perspective. The Surgical Aspects of Pancreas Procurement for Pancreatic Islet Transplantation. Pancreas Preservation for Islet Isolation. Aspects and Challenges of Islet Isolation. Percutaneous Portal Vein Access: Radiological Aspects. Care of the Islet Transplant Recipient - Immunosuppressive Management and Complications. Islet Graft Monitoring and Imaging. Metabolic Measures of Islet Function and Mass After Islet Transplantation. Challenges in Setting Up a New Islet Transplant Program. Key Factors to Consider in Setting Up Clinical Trials in Islet Cell Transplantation: A Nursing Coordinator's Perspective. Clinical Outcomes and Future Directions in Islet Transplantation. Culture and Transportation of Human Islets Between Centers. Development and Application of Contemporary Immunosuppresion in Human Islet Transplantation. Pig Islet Xenotransplantation-Update and Context. Approaches to ß-cell Regeneration and Neogenesis. Stem Cell Approaches for ß-cell Replacement. Diabetes Gene Therapy
A. M. JAMES SHAPIRO is Professor of Surgery, Division of General Surgery, University of Alberta, Canada, and Director of Clinical Islet Transplant Program, Staff Surgeon, and Director of the Juvenile Diabetes Foundation Clinical Center for Islet Transplantation, University of Alberta Hospital, Canada. Dr. Shapiro received his M.B.B.S. from the University of Newcastle on Tyne, England, and his Ph.D. in Experimental Surgery, University of Alberta. Dr. Shapiro currently investigates islet transplantation for the treatment of type 1 diabetes and the immunobiology and tolerance induction for islet cell transplantation, and currently has written over 150 peer reviewed articles and over 15 books and chapters in the field of diabetes.
JAMES A. M. SHAW is a Senior Lecturer in Diabetes at the University of Newcastle within the Institute of Cellular Medicine, Institute of Cell and Molecular Biosciences and the North East Stem Cell Institute. He is a consultant physician in the Newcastle upon Tyne Acute Hospitals Foundation Trust and the Newcastle Primary Care Trust. Dr Shaw received his BSc from St Andrews University, Scotland; MB ChB from the University of Manchester, England; and PhD from the University of Aberdeen, Scotland. He held a Medical Research Council Training Fellowship and GlaxoSmithKline Senior Fellowship. He is a Fellow of the Royal College of Physicians of Edinburgh. In addition to his clinical interests in insulin pump therapy, pancreas and islet transplantation, his research group are exploring gene therapy for diabetes and beta cell replacement including stem cell approaches.
"This is an excellent collection of chapters by leading experts and will likely become the standard reference for practitioners of islet transplantation. The revolutionary change in success rates and basic development since the Edmonton protocol and international enthusiasm for program development in this area make this a timely publication and a necessary update to Dr. Ricordi's 1992 book on the subject … Nonetheless, this book is an instant and welcome standard for programs, clinicians, and researchers striving to maximize and improve outcomes for patients undergoing islet transplantation." —Marc Rider Garfinkel, MD (University of Chicago Pritzker School of Medicine), Doody’s Reviews