What is ISLET transplantation?

Hi Timothy

Currently, the procedure benefits people with diabetes who are at risk of hypoglycaemia, a potentially coma-inducing condition. It provides protection from such events and can sometimes allow patients to be free of insulin dependence. In time, it has the potential to help many more people with Type 1 diabetes. Islets are groups of cells in the pancreas which contain the insulin-producing beta cells. These cells make insulin as needed in order to keep blood glucose levels just right.

In people with Type 1 diabetes the beta cells are destroyed so they must take insulin by injection to remain healthy. This means having to estimate how much insulin they will need and for some people it is very difficult to achieve stable blood glucose levels.

From April 1 2008, the Department of Health has funded two islet isolation laboratories, one in London jointly at King’s College Hospital and The Royal Free, and one in Oxford UK. They will be available 24 hours a day to receive donor pancreases and prepare islet cells for transplantation. Working with the six transplant centres throughout the country – one of which will be based at King’s – the Department of Health announcement means islet transplantation will now be available on the NHS to patients in the UK.

Some more info on Islet transplants. A small number of people with Type 1 diabetes can benefit from islet transplantation. This is a procedure in which an individual’s destroyed islet cells are replaced using cells harvested from donor pancreases.

Typically, a transplant patient will receive islets from up to three donated pancreases. The transplanted cells produce insulin which stabilises the diabetes and reduces the amount of insulin that needs to be administered. In some cases the transplanted cells may produce enough insulin to allow a person to come off insulin completely. Pretty amazing huh?

Yes this is a very exciting area of medicine. In 2000, details of highly successful improvements to the islet transplantation procedure were published by researchers in Edmonton, Canada. These were quickly adopted worldwide. In the UK, Diabetes UK set up the Islet Cell Consortium, which brought together nine islet research centres from around the country to ensure the technique was available here for the benefit of people with diabetes. With the help of our members and supporters, Diabetes UK raised the money needed to pay for the first ten islet transplantations to be done in the UK according to the “Edmonton Protocol”. Since then, Diabetes UK has secured funding to transplant another five patients. Nine of these fifteen transplants have now been successfully performed at three centres of excellence in Oxford and London.

This is definitely a very interesting area that is undergoing radical advances. Islet cell transplantation remains an experimental therapy and is not yet sufficiently well advanced to guarantee insulin independence and freedom from diabetes. Moreover, the drugs required to prevent rejection of the transplant can have serious side effects.

This means the procedure is currently only suitable for those people who have extreme problems controlling their diabetes, experience innumerable hypos with little or no warning which can be life threatening, and as a consequence have drastically reduced quality of life.

I did hear this week that diabetics may be able to have three injections a week instead of one a day, which is also very good news!