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Doody's Review ServiceReviewer: Marc Rider Garfinkel, MD (University of Chicago Pritzker School of Medicine)
Description: This multiauthored book provides a modern and somewhat comprehensive update on clinical and basic scientific aspects of islet transplantation. The scope of the book is very broad, encompassing both practical clinical concerns and recent basic scientific considerations affecting the practice of islet transplantation. This is the first comprehensive book devoted entirely to islet transplantation since Dr. Ricordi's edited work, Pancreatic Islet Cell Transplantation published in 1992.
Purpose: This book brings together leading experts from the multiple disciplines involved in islet transplantation critical to success in the field, with a goal of enhancing clinical outcomes for patients with Type I diabetes potentially undergoing this therapy. This is an important and appropriate time for such a book for at least two reasons. First, the field has advanced significantly since 1992, so an update in the form of a textbook, with all the depth and breadth permitted in such a format, is appropriate given the time interval. Second, the publication of the Edmonton protocol (by Shapiro and others) in 2000 and subsequent successes have created unprecedented enthusiasm at multiple institutions for establishing islet transplant programs, and the practical clinical and infrastructure advice in this book will be useful to any program starting anew, as well as those already in place. These objectives are thoroughly and successfully met in this excellent book.
Audience: As with all forms of transplant, islet transplantation is a field requiring participation from people in a great many disciplines. The target audience for this book is as broad as the list of topics covered and the fields represented by the contributing authors. Anyone associated with islet transplantation, including basic, translational, and clinical scientists, transplant surgeons, diabetologists, interventional radiologists, nurses, program administrators, and others will benefit from reading selected chapters, if not the entire book. Drs. Shapiro and Shaw, themselves irrefutable leaders in islet transplantation and diabetes care, have amassed a cadre of contributing authors who are authorities in their fields.
Features: The book begins with a historical perspective on islet transplantation in general and a discussion of the problem of hypoglycemia, the most common and pressing indication for clinical islet transplantation. Practical clinical advice follows in chapters on patient selection, procurement and preservation techniques, islet isolation, culture and transportation issues, transplantation techniques, and management of immunosuppression. More theoretical consideration is given to measurements of islet mass and function after transplant through imaging and metabolic assessment techniques in subsequent chapters. Most unique are the highly practical and effective guides to programmatic and nursing aspects of establishing and maintaining islet programs. The book concludes with a summary of current clinical outcomes and then more basic and theoretical chapters on alternative tissue sources including xenotransplantation, ß-cell regeneration, and stem cell biology, followed by a closing chapter on gene therapy. The basic science chapters are readable and accessible, offering fundamental definitions and orienting the reader before moving on to current research protocols and results. Chapters are generally thorough and well referenced, although empirical clinical experience predominates in a few sections. A thoroughly populated index facilitates selective reading. Drawings and photographs are entirely black and white, which is limiting only in a very few histologic images. Microencapsulation and other biophysical immunoisolation strategies get only passing mention.
Assessment: This is an excellent collection of chapters by leading experts and will likely become the standard reference for practitioners of islet transplantation. The revolutionary change in success rates and basic development since the Edmonton protocol and international enthusiasm for program development in this area make this a timely publication and a necessary update to Dr. Ricordi's 1992 book on the subject. The breadth of authors and topics is both a strength and a weakness, as it provides nearly comprehensive coverage of relevant topics and accessibility to all, but some readers may find some aspects elementary or not specific to islet as opposed to established solid organ transplantation. Nonetheless, this book is an instant and welcome standard for programs, clinicians, and researchers striving to maximize and improve outcomes for patients undergoing islet transplantation.