While significant progress has been made in the<unk>  transplantation field, many obstacles remain that currently preclude its widespread application. Two of the most important limitations are the currently inadequate means for preventing<unk>  rejection, and the limited supply of<unk> s for transplantation. Current immunosuppressive regimens are capable of preventing<unk>  failure for months to years, but the agents used in these treatments are expensive and may increase the risk for specific malignancies and opportunistic infections. In addition, and somewhat ironically, the most commonly used agents (like calcineurin inhibitors and rapamycin) are also known to impair normal<unk>  function and/or insulin action. Further, like all medications, the agents have other associated toxicities, with side effects such as oral ulcers, peripheral edema, anemia, weight loss, hypertension, hyperlipidemia, diarrhea and fatigue. Perhaps of greatest concern to the person and physician is the harmful effect of certain widely employed immunosuppressive agents on renal function. For the person with diabetes, renal function is a crucial factor in determining long-term outcome, and calcineurin inhibitors (tacrolimus and ciclosporin) are significantly nephrotoxic. Thus, while some people with a pancreas transplant tolerate the immunosuppressive agents well, and for such people diabetic nephropathy can gradually improve, in other people the net effect (decreased risk due to the improved blood glucose control, increased risk from the immunosuppressive agents) may worsen kidney function. Indeed, Ojo et al. have published an analysis indicating that among people receiving other-than-kidney allografts, 7%–21% end up with kidney failure as a result of the transplant and/or subsequent immunosuppression. Another limitation to the<unk>  transplantation process is the inflammatory response of the liver. Dr. Melena Bellin is an Associate professor of pediatric endocrinology and surgery and director of research for the<unk>  autotransplant program at the University of Minnesota Medical Center and Masonic Children's Hospital. Her research centers on making<unk>  transplants safer and more effective for type one diabetics. The process of infusing<unk> <unk> s into the liver can trigger an inflammatory response in the body. This reaction leads to a large amount of the newly transplanted<unk> s being destroyed. Losing<unk> <unk> s decreases the probability of successful insulin production and increases the likelihood of type one diabetes developing again in the patient. Dr. Bellin is currently testing two anti-inflammatory drugs that are already on the market to see if they may be useful in preventing inflammation that destroys<unk> <unk> s.
Islet cell transplantation
Pancreas transplantation
Hepatoportoenterostomy
Intestine transplantation
Enzyme replacement therapy
Intradialytic parenteral nutrition
Distal splenorenal shunt procedure
Liver transplantation