In the last ten years, transplant surgeons have developed techniques and medications that make pancreatic islet cell transplantation increasingly more practical. The most recent stumbling blocks have been the shortage of donor islet cells (it can take up to four cadavers to provide sufficient islets for one recipient) and the relative toxicity of immunosuppressant medications.
Researchers at University of Minnesota have been attacking both difficulties. Last VOICE issue, transplant surgeon Dr. David Sutherland discussed new, more efficient techniques for harvesting islets from a cadaver donor pancreas. A more effective way of removing and collecting islets could profoundly reduce the current islet shortage.
The "Edmonton Protocol" is a breakthrough refiguring of traditional transplant immunosuppression, based on the realization that some immunosuppressants were toxic to the very islets they were administered to protect. The University of Minnesota researchers further modified this protocol, reducing its toxicity, allowing more of the transplanted islet cells to survive.
The immediate goal is to reduce the need for islet cells to the point where one donor pancreas is sufficient -- and preliminary results suggest this goal is within reach. The test, however successful, was very small, with only eight participants, and further tests and clinical studies will be necessary before this new procedure becomes accepted practice. However, it looks good from here.
For further information, see Journal of the American Medical Association,
Volume 293, No. 7, February 16, 2005, pp 836-842, for the article titled: "Single-Donor,
Marginal-Dose Islet Transplantation in Patients With Type 1 Diabetes."