Transplantation of islet cells (in the liver of the receiver) has theoretical advantages over the pancreas transplantation; is the most important that the method is less invasive. A second advantage is that the islet cell transplantation seems to help in the maintenance of normoglycemia. This is the case, requiring a total pancreatectomy due to strong, caused by chronic pancreatitis pain in patients. Nevertheless, this process is under development, but a steady improvement appears to take place.
(. See also Overview of Transplantation) transplantation of islet cells (in the liver of the recipient) has theoretical advantages over pancreas transplantation; is the most important that the method is less invasive. A second advantage is that the islet cell transplantation seems to help in the maintenance of normoglycemia. This is the case, requiring a total pancreatectomy due to strong, caused by chronic pancreatitis pain in patients. Nevertheless, this process is under development, but a steady improvement appears to take place. The disadvantages of islet cell transplantation are that transplanted glucagonsezernierende alpha cells do not function (this may complicate hypoglycaemia) and a plurality of pancreata are required for a single islet cell receiver in the rule (whereby the gap between supply and demand increases and the application is limited) , The indications are the same as for a pancreas transplant. Stood better methods are available, simultaneous islet cell kidney transplant would be desirable. Procedure The pancreas of a brain-dead donor is removed; then collagenase is infused into the pancreatic duct, to separate the islets from pancreatic tissue. A purified islet cells fraction is infused through direct puncture percutaneously into the portal vein or through a branch of the mesenteric vein. The islet cells migrate into the liver sinusoids, where they settle and secrete insulin. The results are best when two bodies are used, each of which two or three infusions of islet cells can be obtained. It follows immunosuppressive therapy consisting of an anti-IL-2 receptor antibody (basiliximab), tacrolimus and sirolimus (Edmonton protocol); Corticosteroids are used sparingly because they cause hyperglycemia. Immunosuppression has a lifetime or be continued until the loss of islet cell function. Complications signs of rejection are weak defined, but they can be recognized by control over deterioration of the Glucksegehalts in the blood and by an increase in glycosylated hemoglobin (HbA1c); treatment of rejection reaction is not yet established. Complications that occur even through the transplant procedure, are percutaneous puncture of the liver with hemorrhage, portal vein thrombosis and Pfortaderhypertonie. Forecast A successful islet cell transplantation is a short time ago a normoglycemia. Whether a long-term normoglycemia can be maintained, is not known. To achieve a longer lasting insulin independence, there may be additional injections of islet cell preparations are necessary.