UK’s nationally funded integrated islet transplant program

© 2020 Elsevier Inc. All rights reserved. Islet transplantation has been funded in the UK by the National Health Service since 2008. Pancreata are optimally procured by the National Organ Retrieval Service and shared equitably between islet and solid organ recipients. Islets are isolated at three central clean room facilities and transported to one of the seven geographically distributed multidisciplinary assessment, transplant, and follow-up centers. Recipients with life-threatening hypoglycemia despite optimized conventional therapy receive up to two sequential islet transplants with the goal of preventing further severe hypoglycemia and attaining optimal overall glycemic control. Over the first 10 years of the program, 243 islet transplants have been performed in 144 recipients. The majority of these (85%) have been islet transplants alone. Non-inferiority of transported versus locally isolated islets has been confirmed with 88% graft function at 1 year associated with median severe hypoglycemia rate of zero and HbA1c 6.8%. This has provided a sustainable platform for ongoing service provision and further innovation.