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Common Questions about Islet Transplantation
- What is islet transplantation?
- Islet transplantation is an experimental procedure by which healthy islets are removed from a donor pancreas, purified and then transferred to a diabetic patient. The beta cells in the implanted islets then begin to make and release insulin, and replace the beta cells that have been mistakenly destroyed by the body in people with Type 1 diabetes.
- What are islets?
- Islets are a group of cells scattered throughout the pancreas that are able to sense sugar in the blood and release the correct amount of insulin to maintain normal sugar levels in the body. In a normal adult pancreas, the islets account for only 1-3% of the organ’s tissue.
- How do islets affect diabetes?
- Beta cells are one of the four types of cells that are found in pancreatic islets. These cells produce insulin that would maintain the proper sugar levels in the blood. In people with diabetes, however, the beta cells are completely destroyed, and therefore, the body is no longer able to produce insulin on its own.
- Why islet transplantation?
- Islet transplantation has been developed as a possible alternative to pancreas transplantation for people with Type 1 diabetes. Islet transplantation is less costly, safer, and less invasive than whole-pancreas transplantation. It is ideal for patients whose symptoms have not developed to advanced stages, and also for those for whom a whole-pancreas transplant may be too risky.
- What type of procedure is required to transplant islets?
- Islet transplants are a minor surgical procedure. A patient receives local anesthesia, and once they are slightly sedated, a catheter is inserted into the portal vein through a needle placed directly below the rib cage. Islets are then injected into the liver through the catheter, where they will begin to function on their own. After the procedure, the patient will be given immunosuppressive drugs to prevent rejection.
- Why are islets transplanted to the liver instead of the pancreas?
- Because of its anatomical position, the liver is easier to reach than the pancreas is. It is also a better environment for the islets to grow in. Once the islets are functioning, they can act as a back-up pancreas by regulating blood sugar and producing insulin.
- What are the benefits of islet transplantation?
- Islet transplantation is not a cure for Type 1 diabetes. It may, however, provide an improved quality of life for patients who become free from insulin injections. There may also be a reduced occurrence of diabetes-related complications. Some patients may have to resume insulin injections, but those who do are able to do so less frequently than they previously could.
- What are the obstacles of islet transplantation?
- The biggest problem that faces patients who have received islet transplantation is rejection. Immunosuppressive drugs must be taken for life to keep the immune system from destroying the transplanted islets.
- Who is eligible to participate in the trials?
- Islet transplants are still an experimental procedure, and therefore are available only to people who meet certain requirements. At this time, only adults with extremely unmanageable glucose levels or hypoglycemic unawareness have been eligible.
- In addition to meeting criteria, the patients must also undergo a medical and psychological evaluation.
- Participation typically requires that a patient applies for the trial, goes through an assessment, and is then placed on a waiting list.
- The trial’s selection committee, which is made up or researchers and physicians, will ultimately decide who is eligible for inclusion in the trial.
- Patients who are interested in receiving islet transplantation sponsored by the VCU Health System should contact their physician to review together the current protocol. Currently, we are conducting only islet-after-kidney procedure.
- The islets-after-kidney transplantation protocol involves individuals with Type 1 diabetes who have had a successful kidney transplant but poor glucose control.
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