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Single-Donor Islet Transplantation for Diabetes—Reply
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In Reply: Achieving and maintaining insulin independence in the majority of recipients with diabetes after their first single-donor islet transplant will be critical to increasing the availability of islet transplants. Otherwise, many fewer candidates for islet transplantation can actually receive a transplant than the donor pool would otherwise allow. We agree with Dr Smith about "using as many donors as possible to treat as many patients as possible" but not as many as are necessary to achieve insulin independence. An inefficient use of donors will hinder the implementation of islet transplantation into health care delivery systems.
Health care delivery continues to be redefined toward end points such as efficacy, cost-containment, equitable allocation of resources, and satisfied health care customers. Given their resource-intensive and expensive nature, islet transplants will face ever-increasing scrutiny by health care professionals and payers. Documentation of substantial evidence of efficacy will be needed for regulatory approval of . . . [Full Text of this Article]
Bernhard J. Hering, MD
bhering@umn.edu
David E. R. Sutherland, MD, PhD
Department of Surgery
University of Minnesota
Minneapolis
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