Transplantation of the islets of Langerhans – present and future. First experience with islet of Langerhans transplantation in Slovakia

Czech version

Authors: Ingrid Dravecká ¹; Igor Gala ²; Tatiana Baltesová ²; Luboslav Beňa ²; Štefan Hulík ³; Peter Girman ⁴
Authors‘ workplace: I. interná klinika LF UPJŠ a UNLP, Košice ¹; Transplantačné oddelenie UNLP, Košice ²; I. chirurgická klinika LF UPJŠ a UNLP, Košice ³; Centrum diabetologie IKEM, Praha ⁴
Published in: Forum Diab 2024; 13(2): 79-89
Category: Review Article

Overview

Diabetes mellitus is a complex metabolic disease with impaired insulin secretion. The standard treatment for autoimmune type 1 diabetes is basal-bolus insulin administration or insulin pump therapy. Other treatment alternatives include transplantation of the islets of Langerhans (LO). Despite its effectiveness, it cannot be performed universally, due to the lack of donors and the need for immunosuppression. Current opportunities in stem cell transplantation provide an alternative to LO transplantation. Despite their therapeutic potential, the clinical viability of transplanted stem cells presents many challenges, including maturation, rejection and survival. Although cells are currently transplanted into the portal vein in the liver, it appears that the hepatic environment may not be suitable for LO function and long-term survival of not only cadaveric but also stem cells. Therefore, it is important to improve the efficiency of transplanted islets by developing biomaterials and using other transplantation sites with better graft survival. In 2023, the first successful allogeneic transplantation of islets of Langerhans in Slovakia was performed at UNLP in Košice in collaboration with IKEM in Prague.

Keywords:

type 1 diabetes – immunosuppression – encapsulation – islets of Langerhans – stem cells -transplantation

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Forum Diabetologicum

2024 Issue 2