CELLULAR TRANSPLANTATION: Edited by Philip J. O’ConnellLong-term effects of islet transplantationHolmes-Walker, D. Janea,b; Kay, Thomas W.H.c,dAuthor Information aDepartment of Diabetes and Endocrinology, Westmead Hospital, Westmead bSydney University Medical School, Sydney, New South Wales cSt. Vincent's Institute of Medical Research dDepartment of Medicine, St. Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia Correspondence to Clinical Associate Professor, D. Jane Holmes-Walker, Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, New South Wales, Australia. E-mail: [email protected] Current Opinion in Organ Transplantation: October 2016 - Volume 21 - Issue 5 - p 497-502 doi: 10.1097/MOT.0000000000000355 Buy Metrics Abstract Purpose of review Islet transplantation has made great progress in recent years. This is a remarkable technical feat but raises the question of what the long-term benefits and risks are for type I diabetes recipients. Recent findings Graft survival continues to improve, and recent multicenter studies show that islet transplantation is particularly effective to prevent hypoglycemic events even in those who do not become insulin-independent and to achieve excellent glycemic control. Concerns include histocompatability leucocyte antigen (HLA) sensitization and other risks including from immunosuppression that islet transplantation shares with other forms of allotransplantation. Summary Reversal of hypoglycemia unawareness and protection from severe hypoglycemia events are two of the main benefits of islet transplantation and they persist for the duration of graft function. Islet transplantation compares favorably with other therapies for those with hypoglycemia unawareness, although new technologies have not been tested head-to-head with transplantation. HLA sensitization increases with time after transplantation especially if immunosuppression is ceased and is a risk for those who may require future transplantation as well as being associated with loss of graft function. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.