Islet Transplant Update

Shalyndria · #1 (**permalink**) 10-03-2004, 12:07 AM

The following is a short synopsis of a report recently published by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) on the results of Islet Transplant:

Quote:

In islet transplantation as performed by these centers, insulin-producing cells derived from donor pancreata were infused into patients with difficult-to-control type 1 diabetes though the portal vein of the liver. When successful, the transplanted islets took up residence in the liver’s small blood vessels and began producing insulin.

The 86 recipients, who had type 1 diabetes for an average of 30 years, received a total of 158 infusions of islets extracted from 173 donor pancreata. Twenty-eight patients received one islet infusion, 44 received two, and 14 received three. At 6 months after the last infusion, 61 percent of recipients no longer had to inject insulin. At 1 year after the last transfusion, 58 percent were still insulin independent. Some insulin-independent patients, although not receiving insulin, did have higher-than-normal blood glucose levels. Researchers will continue to monitor patients to see how long they remain insulin independent.

You can read the whole report
here

On a related note, I had a look at the U of A website (the Uni of Alberta here in Edmonton) and they list this as the following criteria for acceptance:

Current Indications for islet Cell Transplantation:

1. Type 1 Diabetes (Age over 18-65)
2. Unawareness of low blood glucose
3. Brittle Diabetes (You are using a good regimen and are still experiencing wide swings of blood sugar that disrupt your life)
4. Progressive complications of diabetes such as vision, kidney, nerve or blood vessels problems
5. Have had diabetes for at least five years
6. Resident of Canada
If anyone's interested in having a look or filling out an application, check the website out: Edmonton Protocol
They also have a list outlining what makes one ineligible for the program :p

Shy

Littlebit63_99 · #2 (**permalink**) 10-03-2004, 07:07 AM

These are the same criteria followed for transplants at the University of MN.

SunniD · #3 (**permalink**) 10-03-2004, 09:13 PM

I believe from my experience when I tried you also have to have a normal BMI which is easier said than done.<smile>

SunniD

duck · #4 (**permalink**) 10-04-2004, 10:31 AM

I know the article indicated that the recipients were taking immuno-suppresant drugs, I'm assuming that means they keep taking it for the rest of their lives?

archimeech · #5 (**permalink**) 10-04-2004, 10:54 AM

That's great for you guys up there, but us poor Yanks still have to wait for the Clinical Trials to change.... Oh Canada, oh Canada....

Shalyndria · #6 (**permalink**) 10-04-2004, 12:55 PM

Quote:

Originally posted by duck
I know the article indicated that the recipients were taking immuno-suppresant drugs, I'm assuming that means they keep taking it for the rest of their lives?

Yes duck, unfortunately that's one of the drawbacks of this procedure, and the reason that there's a select criteria for acceptance. There's a sense of trading one condition for the other, and unless one is exhibiting critical, life threatening effects it's just not worth it.

Shy

What exactly is a yankee archimeech?? Inquiring minds want to know....

leking · #7 (**permalink**) 10-04-2004, 04:36 PM

what do the immuno-suppresant drugs do exactly?

and what are the side-effects?

Shalyndria · #8 (**permalink**) 10-04-2004, 06:14 PM

Immunosuppressants, as their name suggest, suppress the immune system just enough to prevent rejection of transplanted organs or islet cells (as in this case). As far as I'm aware, immunosuppressants are taken as long as the organ/islet cells last, with the most intensive therapy given just after transplantation.

There's a host of side-effects that can come along with immunosuppressants, and they may vary with the different drugs. The most common, of course, is a risk of infection due to a decrease in your immune system. Pneaumonia, renal effects (the drugs are hard on the kidneys), hypertension, neurotoxicity, gastrointestinal problems (nausea, vomiting, diarrhea), CMV (cytomegalo virus), EBV (epstein-barr virus) and low WBC count are among the few.

Sounds doom and gloom, but there's definitely a positive outcome for people who are experiencing health problems.

Shy

Biagia · #9 (**permalink**) 10-05-2004, 11:44 AM

Hi...yes you do have to take anti-rejection drugs for the rest of your life..including many other medicines to control the side effects etc. My father had a heart transplant and takes up to 40 pills a day. I know it's a different organ but I'm sure in other ways very similar. The quality of life is so much better and I'm sure anyone would rather take a bunch of pills rather than dealing with a serious illness. He does have to watch certain things because of course his immune system is very low and the minute he gets sick he has to go to the hospital. He's going on 4 years and doing SO well.

leking · #10 (**permalink**) 10-05-2004, 06:06 PM

so, unless you are having serious problems controlling your diabetes, diabetes is better than hte transplant?

HeatherP · #11 (**permalink**) 10-05-2004, 09:06 PM

Leking, I think that's a decision that a person has to make for themselves. At this point in time, much as I hate the day-to-day crud that goes along with Diabetes, I'm not interested in having a transplant. The standards for being a candidate are very strict as well.

I do think however, they usually only do pancreas transplants in conjunction w/ kidneys but that may not be the most current info, just my impression.

I can barely gag down my 9-12 vitamins and nutritional supplements each day. I cannot begin to imagine 40 + pills!

HeatherP

leking · #12 (**permalink**) 10-06-2004, 05:05 AM

lol, yep, thats quite alot of pills!

but if it stops you having to worry about hypo's and hyper's, then it might be worth it.

also, you can still do the things you want to in life whilst taking these drugs? like playing sport and drinking alcohol?

Shalyndria · #13 (**permalink**) 10-06-2004, 01:03 PM

Quote:

Originally posted by leking
so, unless you are having serious problems controlling your diabetes, diabetes is better than hte transplant?

Well, I guess that depends on the person. However unless you're experiencing serious problems as a result of the Diabetes, you will not get on a transplant list. There's only so many organs to go around, and the most critical usually get the first shot. And there's an average life of transplanted organs - they usually only last about 10 years before another transplant is required.

Heather, surgeons will do a pancreas transplant alone if the kidneys are still healthy; it is when the kidneys are being transplanted in a diabetic that they usually transplant the pancreas as well, so that the viability of the kidneys is preserved.

Shy

Biagia · #14 (**permalink**) 10-06-2004, 01:16 PM

Well in reference to how strict they are with who gets the transplant or not...they did test after test after test...making sure the only thing my father needs is a heart. They don't want to risk giving an organ to someone who has other medical problems over someone healthy otherwise. You can be on the list years!

Leking...you can have a normal life minus the drinking. Abusing the organ such as smoking and drinking can cause your organ to reject and put you back to square one. Now again...not sure about the pancreas...I'm speaking on what I know about heart transplant. My fiance's brother had kidney transplant...now I see him drinking every once in awhile...each organ can have different restrictions or he just is one to abuse it....but not sure and never asked.

Taking 40+ pills isn't so bad...just have to stay on routing (4x a day)