Eligibility of patients with type 1 diabetes for islet transplantation alone
| Autor: | Thierry Berney, Axel Andres, Giacomo Gastaldi, Mohamed Alibashe-Ahmed |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
geography Type 1 diabetes geography.geographical_feature_category endocrine system diseases Edmonton protocol business.industry medicine.medical_treatment Renal function Immunosuppression Hypoglycemia Islet medicine.disease Transplantation medicine Risks and benefits business Intensive care medicine |
| Popis: | Islet transplantation is currently primarily performed as islet transplantation alone (ITA). This is especially the case in North America, less so in the rest of the world, since the turn of the millennium and the publication of the Edmonton protocol. The main indication for ITA is “problematic hypoglycemia,” a term describing patients experiencing repeated episodes of severe hypoglycemia, mostly due to hypoglycemia unawareness. Candidates usually have normal kidney function. The risks and benefits of exposure to long-term immunosuppression should therefore be carefully balanced before selecting patients for ITA, a concern that is not present in uremic patients who are also candidates for a kidney transplant. The different parameters to take into account for selecting patients for ITA are reviewed in this chapter, as well as the tools for assessment at baseline and during posttransplant follow-up. Criteria for directing patients with problematic hypoglycemia toward pancreas or islet transplant alone are also discussed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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