Whole-pancreas transplantation

Whole-pancreas transplantation can significantly improve the quality of life of people with diabetes and prevent the acute complications experienced by patients. However, lifelong immunosuppression is required to prevent rejection of the graft, leading to frequent and severe side effects. Therefore, this procedure is restricted to use in patients who have serious complications of diabetes and a highly-degraded quality of life. Pancreas transplantation carries a small, but not negligible, risk of mortality.

Transplantation of purified human islet cells

An alternative which has been increasingly successful in recent years consists in transplanting human islets purified from donor organs by infusion in the portal vein of the liver. This therapy can currently decrease or remove the need for insulin injections, but its further development is limited by the shortage in human donor organs. There is therefore a need for large-scale preparation of grafts. The search for alternative sources such as stem cell-derived preparations has become a major field of investigation in diabetes.

The Functional Beta Cell Mass (FBM) reflects the number of beta cells present in the pancreas of an individual, and their ability to produce insulin. In a healthy individual (top), it is increased during foetal life and childhood and then stays relatively stable. In a diabetic individual, a still poorly understood trigger induces a loss of beta cells, which is not directly detected before clinical diagnosis. Beta cell replacement can restore a FBM to levels sufficient to improve the patient’s condition.