Type 1 diabetics "off insulin" after islet transplantation

Julia Rommelfanger

May 18, 2000

Thu, 18 May 2000 19:14:11

Chicago, IL - Transplant surgeons at the University of Alberta have successfully achieved sustained insulin independence in eight type 1 diabetics through solitary islet transplantation. The breakthrough surgery was presented by lead investigator Dr James Shapiro (University of Alberta, Edmonton, AB) and his colleagues on May 17, 2000 at Transplant 2000, a joint conference of the American Society of Transplant Surgeons and the American Society of Transplantation.

In an earlier report from the International Islet Transplantation Registry only 12.4% of the 267 islet allographs with steroid-based immunosuppression performed in type 1 diabetics over the last 10 years became insulin independent beyond 1 week. In contrast, Shapiro pointed out that all eight of his study patients, 29 to 53 years old, and diabetics for 18 to 50 years, attained immediate and sustained independence from insulin for a median of 11 months after an average of two islet transplants. The key to success, he said, was the administration of immunosuppressive drugs in a new way to block T-cell activation and proliferation without introducing steroids, and the delivery of a sufficient amount of beta-cell mass after islet preparation.

PATIENTS LEADING "COMPLETELY NORMAL LIVES" POSTSURGERY

The insulin-producing islet cells were extracted from the pancreas of a healthy donor and were transplanted immediately, without tissue culture, by percutaneous transhepatic portal venous embolization. The researchers reported no episodes of acute rejection, no elevation, and no serious side effects.

Besides being "totally off insulin" Shapiro said his patients displayed "complete control" of hemoglobin A-1C, a marker in red blood cells which signals damage from high blood-sugar levels. He told surgeons in Chicago that they were all leading completely normal lives now, without insulin injections or strict diets.



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