Pancreas islet stem cells and transplant for the treatment of diabetes mellitus

PICHON RIVIERE, A.; AUGUSTOVSKI, F.; ALCARAZ, A.; BARDACH, A.; COLANTONIO, L.; FERRANTE, D.; GARCIA MARTI, S.; GLUJOVSKY, D.; LOPEZ, A.; REGUEIRO, A.; CALCAGNO, J. I.

Documentos de Evaluación de Tecnologías Sanitarias

IECS

Año: 2006 p. 1 - 30

1668-2793

This report aims to assess the evidence available on the use of pluripotential stem cells or pancreas islets for the treatment of patients diagnosed with diabetes mellitus.A search was performed in the University of York's Center for Reviews and Dissemination (CRD) database, in MEDLINE, Trip database and Cochrane library, to identify published studies which have assessed stem cell development and pancreas islet transplant techniques for the management of Type 1 diabetic patients. Priority was given to secondary studies (meta-analyses, systematic reviews and health technology assessments). In addition, coverage policies from other countries health care providers were reviewed.There are no international studies published which have assessed the effectiveness of treatment with pluripotential stem cells in humans as this technique is still at the initial stages of experimentation.There are several case series reports published on pancreas islet transplants, with few patients included and mid-term follow-up. These studies were conducted in patients between 18 and 65 years old, with more than five years of diagnosis of Type 1 Diabetes Mellitus, with episodes of severe asymptomatic hypoglycemia, severe metabolic lability and follow-up and insulin therapy optimized by a specialist. Besides, the results found show that mean insulin-independence was 15 months; only 10% continue in this condition after five years. However, patients progress with lower metabolic lability, thus requiring less than 50% of the insulin dose received before the transplant.