الفهرس | Only 14 pages are availabe for public view |
Abstract Type I diabetes accounts for 10% of diabetic patients in the world. The uncontrolled diabetes is associated with several complications including diabetic retinopathy, diabetic nephropathy, vascular, and neurological complications. The mainstay treatment for Type I diabetes is insulin injection. However, insulin administration is associated with several shortcomings, most importantly the hypoglycemic unawareness episodes, in addition to cost and inconvenience. As a definitive and physiological treatment, pancreatic and pancreatic islet transplantation were developed. Pancreatic transplantation is successful in maintaining normoglycemia and is commonly associated with favorable outcome. Despite of that, the procedure is largely invasive, associated with surgical complications, and requires life-long immunosuppression. As compared to pancreatic transplantation, the pancreatic islet transplantation is less invasive and requires less immunosuppressive treatments and can be repeated. With technical advances of islet isolation and transplantation, the outcome of islet transplantation is currently similar to that of pancreatic transplantation in experienced centers. To achieve these results, islets from two or more donors are usually necessary. The standard site for clinical islet transplantation is the intraportal route. This route is, however, associated with a significant loss of transplanted islets immediately after transplantation. In addition, the islets become dispersed within the liver making it technically difficult to follow and impossible to retrieve. This suboptimal transplantation site is one of the main reasons for the requirement of multiple pancreatic donors per one recipient. Therefore, many studies focused on finding a more suitable transplantation site in experimental small animal models and preclinical non-human primate models. Due to the anatomical and histological resemblance between the submandibular gland and the pancreas, the submandibular gland was proposed as an alternative site for pancreatic islet transplantation. A few studies showed varying degrees of success with intraglandular transplantation. However, the results were inconsistent and a true intraparenchymal localization was not evidently achieved. |