Antonio Bruni, Michael McCall, A. M. James Shapiro
Springer Berlin Heidelberg
For a subset of patients with complicated Type I Diabetes Mellitus (T1DM), islet transplantation has become a well-established treatment modality. Before 2000, fewer than 9% of islet transplant recipient maintained insulin independence for greater than one year. The improvements resulting from the Edmonton Protocol have led to high rates of one-year insulin independence, and together with an international collaboration, propagated the expansion of clinical islet transplantation centers worldwide. In spite of the continued success of clinical islet transplantation, a number of limitations with this therapy remain, including the requirement for lifelong immunosuppression with the associated side effects. While islet transplantation is currently generally reserved for adults with T1DM with severe hypoglycemia or glycemic lability, we herein consider the possibility of its application to the pediatric population, moving this therapy one day from a treatment for some to a potential cure for all.