Islet Cell Transplantation Great for Some, OK for Others, Disappointing for a Few

10/05/06 Clinical Trials, Research, General

A few days ago, the researchers heading up the islet experiment called the “Edmonton Protocol” reported on their results with the first 36 patients to undergo islet transplantation in this study. When we read the results we could see that they were mixed. The headline depended on the interpretation the writer or editor chose to take at each newspaper, television station, or blog.

For example there is this headline: Power of diabetes ‘cure’ fades over long term downplays the miracle. This headline: New Hope for Type 1 Diabetes implies optimism. A print headline I read declared, “Cell Transplants For Diabetics Miss Researchers’ Goal”.

Again, there were 36 patients in the study. Fourteen of them still did not need insulin a year after their transplant. After two years, only five remained free of the need of insulin injections. Some people had hoped for higher numbers. We think that this is a wonderful result for such an immature science. With time and knowledge, we’ll learn how to improve the odds. We think that this is still one of the medical miracles of our era.

Islet transplantation is simply taking islet cells from a deceased donor’s pancreas, and transplanting them in the liver of a person with Type I diabetes. There in the liver they often succeed at producing insulin. It is not a permanent change. Eventually, most bodies are not able to continue producing insulin in the liver with islets.

Let’s do some thinking here for a minute. Some people were discouraged by the fact that only five of the study subjects needed no insulin after two years. While I understand their concern, I ask questions like:

• Even if they were insulin independent for only a few months, did it provide enough time for a diabetic ulcer to heal up?

• Did it allow that patient the opportunity to get adequate rest for a few months?

• Did it provide relief to overtaxed kidneys, so that they would be more prepared to “do battle” further down the road?

• Did living insulin independent for a few months push back any of the diabetic risks for longer than those few months?

If you would like a brief introduction to the science of islet cell transplants, click here to visit the Mayo Clinic’s website.