The two transplant procedures are done either simultaneously, or kidney first, then islet or whole pancreas transplant. Generally, either islet transplant or whole pancreas transplant is appropriate when a kidney transplant is also required. Islet transplantation is technically simple, does not require an incision, has a short recovery, but frequently does not result in long-term insulin independence. These are the main factors to consider when deciding between islet and whole pancreas transplantation. The ultimate goal of islet transplantation is the normalization of blood glucose levels and the prevention of secondary complications of diabetes.
Success depends upon overcoming the barriers to islet transplantation described earlier.
Researchers are now striving to gain a better understanding of the immune barriers, especially autoimmunity. Even now, there is cause for optimism. New immunosuppressive medications are being developed that appear to be less diabetogenic than some of the current antirejection drugs. The improvements in islet isolation and immunosuppressive medication now hold promise for achieving better results in islet transplantation for type 1 diabetic patients.