Diabetes: Islet Cell Transplantation
In islet cell transplantation, insulin-producing beta cells are taken from a
donor's pancreas and transferred into a person with diabetes. Once transplanted,
the donor islets begin to make and release insulin, actively regulating the
level of glucose in the blood.
What Are the Benefits of Islet Cell Transplantation?
A successful islet cell transplant can significantly improve the quality of
life for a person with diabetes.
Once transplanted, the islet cells automatically monitor sugars levels and
can regulate insulin levels by delivering the appropriate amounts needed to
normalize blood glucose levels, even as the body's needs change (for example,
after exercising or eating).
Successful transplantation can provide the following benefits:
- It can eliminate the need for frequent blood glucose measurements and the need for daily insulin injections. Although only a few are free of insulin injections a year after transplantation.
- It can provide more flexibility with meal planning.
- It can help protect against the serious long-term complications of diabetes, including heart disease, kidney disease, stroke and nerve and eye damage.
What Are the Risks of Islet Cell Transplantation?
As with any organ or tissue transplant, rejection of the donor cells is the
greatest challenge. The immune system serves to protect the body from "invading"
substances that do not belong -- bacteria and viruses, for example. Even when
needed donor tissue is transplanted, the recipient's immune system recognizes it
as "foreign" and tries to destroy it. This attack on the donor tissue is called
"rejection."
All transplant recipients must take, for the rest of their life, strong drugs
to suppress the immune response and prevent rejection. Many of these drugs have
serious side effects. The long-term effects of these immunosuppressive or
anti-rejection drugs are not yet known, but it is suspected that they may
increase the risk of cancer.
How Successful Is Islet Cell Transplantation?
Scientists developed the procedure for isolating islet cells in the 1960's.
The first transplantation attempts, which began in the 1990's, succeeded only 8%
of the time, which was attributed to the fact that anti-rejection drugs
available at the time interfered with insulin's effectiveness.
But in 1999, a clinical trial conducted at the University of Alberta in
Edmonton, Canada, brought new hope. Using enhanced techniques to collect and
prepare the extremely fragile donor islet cells, as well as using improved
anti-rejection drugs, the researchers achieved a 100% success rate. All of the
patients in their trial were freed from the need for insulin for at least one
month. Ten of those 15 patients remain insulin free today, and the other five
have a significantly reduced need for insulin. The process followed by the
researchers -- dubbed the "Edmonton Protocol," -- is still being studied in
clinical trials around the world.
To date, about 400 patients worldwide have received islet cell transplants
from donor pancreases, with varying degrees of success.
Next: Can anyone with diabetes get an islet cell transplant? »
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