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Transplantation. 2018 Feb;102(2):215-229. doi: 10.1097/TP.0000000000001937.

β Cell Replacement Therapy: The Next 10 Years.

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Center for Transplantation Sciences, Transplant Surgery Division, Department of Surgery. Massachusetts General Hospital, Boston, MA.
Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, University of Kyoto, Kyoto, Japan.
Islet Transplant Research Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
Department of Biochemistry, Chemistry Institute, University of São Paulo, São Paulo, Brazil.
Cell Isolation and Transplantation Center, Department of Surgery, University of Geneva Hospitals and School of Medicine, Geneva, Switzerland.
Division of Transplant Surgery, Department of Surgery, University of Wisconsin, Madison, WI.
Department of Transplant Medicine and Institute for Surgical Research, Oslo University Hospital, Oslo, Norway.
Department of Surgery, University of California, San Francisco, CA.
Transplantation Immunology Group, Immunology Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.


β cell replacement with either pancreas or islet transplantation has progressed immensely over the last decades with current 1- and 5-year insulin independence rates of approximately 85% and 50%, respectively. Recent advances are largely attributed to improvements in immunosuppressive regimen, donor selection, and surgical technique. However, both strategies are compromised by a scarce donor source. Xenotransplantation offers a potential solution by providing a theoretically unlimited supply of islets, but clinical application has been limited by concerns for a potent immune response against xenogeneic tissue. β cell clusters derived from embryonic or induced pluripotent stem cells represent another promising unlimited source of insulin producing cells, but clinical application is pending further advances in the function of the β cell like clusters. Exciting developments and rapid progress in all areas of β cell replacement prompted a lively debate by members of the young investigator committee of the International Pancreas and Islet Transplant Association at the 15th International Pancreas and Islet Transplant Association Congress in Melbourne and at the 26th international congress of The Transplant Society in Hong Kong. This international group of young investigators debated which modality of β cell replacement would predominate the landscape in 10 years, and their arguments are summarized here.

[Indexed for MEDLINE]

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