Current Transplant Options for Type I Diabetes

Author: James Shapiro, MD, PhD, FRSC

Learning Objectives:

1. Understand the relative potential benefits of pancreas vs islet transplant
2. Appropriately assign patients for consideration of pancreas vs islet transplant 
3. Understand that both treatments currently require full dose immune suppression to prevent allograft rejection (or recurrence of T1D autoimmunity)
4. Describe short and long term outcomes with patient and graft survival in whole pancreas transplantation, and that metabolically endocrine function currently remains superior with a whole graft
5. Describe the technical implantation technique for pancreas (Y-graft, systemic venous drainage, enteric exocrine drainage), vs intraportal non-surgical percutaneous transhepatic access for islet transplantation
6. Describe recent research progress with stem cell derived islets could one day provide successful transplants with less (or no) immune suppression