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Islet Cell Transplant: New Hope for Type 1 Diabetics

An islet cell transplant is a new and promising treatment for Type 1 diabetes. Diabetes is a disease that’s marked by the body’s inability to produce enough insulin, a hormone that helps the body to use glucose (sugar) for energy. Until now, the most prevalent treatment for Type 1 diabetes has been regular injections of insulin. While islet cell transplant is still in its infancy, its potential as a viable alternative to insulin injections provides hope to many people with diabetes.


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What is Islet Cell Transplant?
Islet cells are the cells in the pancreas that produce insulin. The pancreas is a hand-sized organ that’s positioned behind the lower part of the stomach.

The two types of islet cells are alpha cells and beta cells. Alpha cells make glucagons, hormones that raise the body’s blood sugar level. Beta cells manufacture insulin. If the beta cells don’t produce enough, the result is Type 1 diabetes.

Islet cell transplantation is a process by which beta islet cells are taken from a donor pancreas and transferred to someone who suffers from Type 1 diabetes. Once implanted in the recipient, the new islet cells should begin to manufacture and release insulin. The hope is that islet cell transplants will become the alternative to insulin injections.

Islet Cell Transplant: Still Very New
The process, while promising, is still being clinically tested. Like any transplant, the procedure is not without risks. Most significant is the possibility of rejection.

The human immune system is programmed to destroy bacteria, viruses and any tissue that might be recognized as foreign to the body. Thus, new beta islets transplanted from a donor could very well be rejected by the host.

In order to minimize the possibility of this immune response, immunosuppressive drugs are often needed to keep the transplanted islets functioning. But immunosuppressive drugs can have significant side effects over the short term and far into the future. These side effects can include:
  • mouth sores
  • higher cholesterol levels
  • decreased white blood counts
  • decreased kidney function
  • increased susceptibility to infection
  • risk of incurring tumors and cancer.
Advantages Over Other Measures
While islet cell transplant has rejection risks, it is still considered far less intrusive than a pancreas transplant. In fact, an islet cell transplant often takes less than an hour to complete—and it’s all done with a local anesthetic.

The procedure is almost simple, following these basic steps:
  • Identify and extract a pancreas from a recently deceased donor.
  • About one million beta islet cells are needed for a successful transplant into an average sized person. In some cases, two donor pancreases are required.
  • The islet cells are infused into the recipient’s liver, directly through the portal vein.
  • Once infused in the recipient, the new islet cells work to regulate blood sugar and produce insulin.
NOTE: The new cells are affixed to the recipient’s liver (as opposed to his or her pancreas) because physicians can more easily gain access to the liver. Also, the transplanted islet cells often grow well in the liver that, in this way, acts as a back-up pancreas.

The new islet cells start to function gradually. Meanwhile, recipients continue to take insulin until their new islet cells start to produce enough insulin on their own.

The procedure has shown a strong measure of promise, and researchers are continuing to refine the process. Some researchers are proposing that human stem cells function as islet cells, and the possibility of using animal islet cells is growing. The procedure is still years away from becoming universally accepted, but islet cell transplant is indeed a promising procedure, one that offers great hope for those with Type 1 diabetes and their loved ones.

Resources

Mayo Clinic.com. (September, 2003). Islet cell transplantation: The diabetes treatment frontier.

National Diabetes Information Clearinghouse. (November, 2003). Pancreatic islet transplantation.
   
   
 
 
 
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Last modified 18 September 2006
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