Rapports de transplantation : accès libre

Abstrait

Advancements in Pancreatic Transplantation: A Comprehensive Review

Russell D

Pancreatic transplantation has emerged as a pivotal therapeutic option for individuals with end-stage diabetes mellitus, offering a potential cure and improved quality of life. This comprehensive review explores the recent advancements in pancreatic transplantation, encompassing both technical and immunological innovations. The paper provides an in-depth analysis of various transplantation techniques, including simultaneous pancreas-kidney (SPK) and solitary pancreas transplantation, highlighting their respective benefits and limitations. Immunosuppressive strategies play a critical role in ensuring the success of pancreatic transplantation. The review examines the latest developments in immunosuppressive protocols, with a focus on minimizing rejection while mitigating side effects. The advent of precision medicine in tailoring immunosuppression to individual patient profiles is explored as a promising avenue for enhancing long-term graft survival. Islet transplantation, an evolving alternative to whole organ transplantation, is also discussed in detail. This section covers the recent breakthroughs in islet isolation, encapsulation technologies, and the utilization of novel biomaterials to create a microenvironment conducive to islet engraftment. The potential of stem cell-based therapies in regenerating pancreatic tissue and overcoming the shortage of donor organs is explored as a futuristic approach. In addition to technical and immunological aspects, the review delves into the economic and ethical dimensions of pancreatic transplantation. It analyzes the cost-effectiveness of transplantation compared to conventional diabetes management and discusses the ethical considerations surrounding organ allocation and donor procurement. The emergence of artificial intelligence (AI) and machine learning in predicting graft outcomes and personalizing treatment plans is another focal point. The review evaluates the current state of AI applications in pancreatic transplantation and envisions future possibilities for improving patient selection, post-transplant monitoring, and overall graft management. Overall, this comprehensive review provides a panoramic view of the advancements in pancreatic transplantation, emphasizing the interdisciplinary collaboration between transplantation surgery, immunology, bioengineering, and data science. By synthesizing the latest research findings and technological breakthroughs, this review aims to contribute to the collective knowledge driving progress in the field of pancreatic transplantation.