News From Transplant Week of May 5, 2002 / Vol. 3 No. 18

 

Islet Cell Transplant Update: 70 % Insulin-Free After Two Years
 

Researchers from the University of Alberta report that experimental transplants of insulin-producing islet cells using a technique pioneered in Edmonton have now been performed on 122 diabetics in Canada and 9 centers in the United States.

Dr. James Shapiro, presenting an update on the technique unveiled two years ago at Transplant 2000, said 70 percent of the 33 patients who have received islet transplants from his team have had no need for insulin injections for two years.

But despite a growing number of successes for the so-called Edmonton protocol in freeing Type 1 diabetics of the need for daily insulin injections, some doctors question whether the results outweigh the risks.

Dr. David Harlan, a researcher at the National Institutes of Health which is sponsoring the study of the Edmonton protocol in the United States, told The Washington Post the question no longer was "can this work" but rather "should we do it."

While islet transplants do not require conventional surgery, with a large needle being inserted through the abdominal wall to transport the islets to the liver, complications reported in Edmonton have included internal bleeding in two patients, puncture of the gall bladder in two, and clotting in a large vein in one patient.

Shapiro said a few patients also experienced infections or reduced kidney function. Harlan said some of the six patients he has transplanted have experienced anemia, tremor, swelling of the legs, joint pain and fatigue.

And like patients receiving organ transplants, patients receiving the islet transplants have to take daily immunosuppressive medications.

"You're really substituting insulin . . . for someone using immune-suppressive drugs," Harlan said. "The question is: Which is safer long-term?"

Other sources: University of Alberta, Washington Post