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Islet transplantation has experienced significant progress over the past decades, transforming an experimental procedure into an established option for selected patients with type 1 diabetes. Compared to solid organ transplantation, the mandatory multistep conditioning of the pancreas prior to islet transplantation, and the technological infrastructure and know-how it implies, have encouraged the creation of multicenter networks early in the development of islet transplantation programs. The first islet transplantation network created was GRAGIL. It is an example of successful collaboration across national borders, and has contributed and adapted its practices to the successive advances in the field. This chapter describes the rationale for an islet transplantation network, the logistics involved, and the different challenges faced and addressed by the network. These points are illustrated by the several clinical trials completed by GRAGIL and discussed from the network point of view and in perspective with concurrent advances in the field. |
