Islet Cell Transplantation for the Treatment of Diabetes
Can Anyone With Diabetes Get an Islet Cell Transplant?
Typically, candidates for islet cell transplantation are between the ages of 18 and 65, have had type 1 diabetes for more than 5 years, and are experiencing diabetes-related complications, such as frequent periods of unconsciousness due to lack of insulin and early signs of kidney problems that could lead to kidney failure.
As with all medical procedures, the benefits and risks must be weighed carefully. Transplantation is reserved for those with serious complications of diabetes.
Can Islet Cell Transplantation Be Done at Any Hospital?
Because it is still considered an experimental therapy, islet cell transplantation for diabetes is not widely available. There are currently 17 U.S. centers participating in islet cell research programs. The American Diabetes Association recommends that pancreas or islet cell transplantation be performed only in certain major centers, which are best equipped to handle the complex and long-term medical and personal needs of transplant patients.
What Is the Future of Islet Cell Transplantation Research?
There are two main areas of focus in islet cell transplantation research:
- Collecting enough islet cells to do the transplant: Obtaining enough islet cells for transplantation is a major challenge. In most cases, islet cells from several different donors are needed. Because the need surpasses the number of human donors available, researchers are studying the use of cells from other sources, including fetal tissue and animals such as pigs. Researchers are also attempting to grow human islet cells in the laboratory.
- Preventing rejection: Researchers are continuously seeking to develop new and better anti-rejection drugs. Many advances have been made in anti-rejection drugs over the past 15 years. Newer drugs -- such as tacrolimus (FK506) and rapamycin -- have fewer and less harmful side effects than some older drugs like cyclosporine and prednisone.
Researchers are also working to develop methods of transplanting islet cells that will reduce or eliminate the risk of rejection and the need for immunosuppression. One approach involves coating the islet cells with a special gel that prevents the immune system from recognizing and targeting the donor cells.