Programs

Kidney/Pancreas Transplantation

Islet Transplantation

Islet transplantation is a potential cure for Type I diabetes that afflicts nearly two million persons in the United States. Insulin producing pancreatic islets are taken from a donor pancreas. During the transplant, the surgeon places a small plastic tube (catheter) through the upper abdomen and into the liver and the islets are then injected through the catheter into the liver. Once implanted, the islets begin to make and release insulin. The goal of islet transplantation is to infuse enough islets to control the blood glucose level without the need of further insulin injections. Often two or more transplants are currently necessary to achieve insulin independence. Because good control of blood glucose can slow or prevent the progression of complications associated with diabetes, such as nerve or eye damage, a successful transplant may reduce these complications. But at this point, a transplant recipient will need to take immunosuppressive drugs for life. These medications are necessary to prevent the immune system from rejecting and destroying the transplanted islets.

Many advances in islet transplantation were made in recent years. Since reporting the findings in the June 2000 issue of the New England Journal of Medicine, researchers at the University of Alberta in Edmonton, Canada, have continued to use a protocol called the "Edmonton protocol." According to the most recent data of a multicenter trial, about 80 percent of the patients have remained insulin-free up to one year, 50 percent up to three years, and 30 percent up to four years after receiving a transplant. Nonetheless, islet transplantation should still be considered experimental, as there are many issues relating to islet isolation, immunosuppression, and transplantation that require active research and development. Currently, new approaches are studied that hopefully will allow successful transplantation without the use of immunosuppressive drugs, thus eliminating the side effects that may accompany their long-term use.

The Mount Sinai Recanati/Miller Transplantation Institute is currently establishing a clinical islet transplant program funded by the National Institutes of Health (NIH) to make this therapy available to our patients.

For more information about islet transplantation, visit www.insulin-free.org.