1 Guidance

1 Guidance

This document together with the guidance published on allogeneic pancreatic islet cell transplantation for type 1 diabetes mellitus replaces previous guidance on pancreatic islet cell transplantation (interventional procedure guidance 13 issued in October 2003).

1.1 The current evidence on autologous pancreatic islet cell transplantation for improved glycaemic control after pancreatectomy shows some short term efficacy, although most patients require insulin therapy in the long term. The reported complications result mainly from the major surgery involved in pancreatectomy (rather than from the islet cell transplantation). The procedure may be used with normal arrangements for clinical governance in units with facilities for islet cell isolation (see also section 2.5.1).

1.2 During consent, clinicians should ensure that patients understand that they may require insulin therapy in the long term. They should provide them with clear written information. In addition, the use of the NICE's information for patients ('Understanding NICE guidance') is recommended.

1.3 Patient selection for this procedure should involve a multidisciplinary team with experience in the management of benign complex chronic pancreatic disease. The procedure should be carried out by surgeons with experience in complex pancreatic surgery and clinicians with experience in islet cell isolation and transplantation.

1.4 Further audit and research should address the long-term efficacy of the procedure, quality of life, insulin independence and the management of patients' diabetes (see section 3.1).