A global online survey was administered to 69 islet transplantation programs, covering 84 centers and 5 networks. The survey addressed questions on program organization and activity in the 2000–2020 period, including impact on activity of national health care coverage policies. We obtained full data from 55 institutions or networks worldwide and basic activity data from 6 centers. Additional data were obtained from alternative sources. A total of 94 institutions and 5 networks was identified as having performed islet allotransplantation. 4,365 islet allotransplants (2,608 in Europe, 1,475 in North America, 135 in Asia, 119 in Oceania, 28 in South America) were reported in 2,170 patients in the survey period. From 15 centers active at the start of the study period, the number of simultaneously active islet centers peaked at 54, to progressively decrease to 26 having performed islet allotransplants in 2020. Notably, only 16 centers/networks have done >100 islet allotransplants in the survey period. Types of transplants performed differed notably between North America and the rest of the world, in particular with respect to the near-absence of simultaneous islet-kidney transplantation. Absence of heath care coverage has significantly hampered transplant activity in the past years and the COVID-19 pandemic in 2020.
Bibliographical noteFunding Information:
It has almost become commonplace to state that islet transplantation has become an established beta-cell replacement therapy since the seminal publication of the Edmonton protocol (). The significant improvement of outcomes reported has led to a multiplication of islet transplant centers and transplant procedures. In comparison to the 237 procedures performed during the 1990–1999 decade and reported to the now defunct International Islet Transplant Registry (ITR) (), 2,150 islet allotransplants have been reported to the Collaborative Islet Transplant Registry in the 1999–2015 period alone (). The CITR is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and previously received support in part from the Juvenile Diabetes Research Foundation (JDRF). Therefore, collection, analysis, and communication of comprehensive and current data on human-to-human islet transplants is limited to those performed in transplant sites in North America, Europe and Australia, with NIDDK and JDRF sponsoring (). As a result, the CITR data are skewed toward North American activity, with 1,146 procedures (53%) reported in Canada and the US alone, and the true number of islet transplant procedures performed worldwide is unknown.
Copyright © 2022 Berney, Andres, Bellin, de Koning, Johnson, Kay, Lundgren, Rickels, Scholz, Stock, White and the International Islet Transplant Centers.
- health care coverage
- islet transplantation
- type 1 diabetes mellitus