For diabetes

Physician-researchers at the Schulze Diabetes Institute hope to one day eliminate type I diabetes through islet transplantation. The method used today -- in its final stage of clinical trial -- is allo-islet transplantation.

This procedure involves inserting islets from a human donor pancreas into the liver. The cells lodge in the liver's small blood vessels and, in most cases, begin producing insulin shortly after infusion.

As is the case for organ transplants, immunosuppressive drugs must be taken to prevent the body from rejecting the cells. Unlike a pancreas transplant, however, islet transplantation does not require major surgery.

During the islet transplant procedure, the patient is under light sedation. The surgeon injects the islets into the portal vein of the patient’s liver. The whole procedure takes 30 minutes to 2 hours.

If successful, the transplanted islets will:

• produce enough insulin so that the transplant recipient will no longer need to take insulin shots or use an insulin pump
• control blood sugar levels in a normal or close to normal range, therefore preventing hypoglycemia (low blood sugar)

With a partially successful transplant, the recipient may benefit from more stable blood sugar control, needing less insulin, with fewer instances of hypoglycemia.

Since 2000, the Schulze Diabetes Institute has completed 4 allo-islet transplant trials involving patients with type 1 diabetes.

None of these patients experienced a serious, unexpected adverse event related to the islet transplant procedure or the immunosuppressive protocol.

• More than 80% of recipients remain protected from severe hypoglycemia 5 years post-transplant
• About 90% of recipients have become insulin-independent post-transplant
• More than 50% have maintained insulin independence at 5-year follow-up

These results are comparable to outcomes previously only attainable by whole-organ pancreas transplantation.

Allo-islet transplants are still experimental, and are currently only being performed in clinical trials; however, planning has begun to apply to the FDA for approval to make alloislet transplantation available as a clinical treatment.