U doctors test cell transplants to aid diabetics

Justin Costley

Building on the success of Canadian researchers, University doctors will begin a study using a procedure pioneered at this campus in 1974.
The trial, which could begin at any time, will transplant insulin-producing islet cells into Type 1 diabetic patients. Three trials will follow this initial one, with 52 patients undergoing the procedure.
Juvenile diabetes, as it has also been known, occurs when these cells, located in a patient’s pancreas, fail to adequately produce insulin. Insulin is a hormone used by the body to regulate a person’s blood sugar.
Dr. David Sutherland, professor of surgery who performed the world’s first islet cell transplant at the University in 1974, said he is excited by the potential for this procedure.
He added it continues a trend of work done by the University’s diabetes institute.
“It will continue our tradition of being in the forefront in providing transplant services for patients in need and will result in expansion of the institute to train others worldwide to also provide the procedure,” he said.
Doctors have long recognized the benefits of cell transplantation vs. pancreas transplants. Because the islet procedure is brief, requiring only an injection through a catheter and a local anesthetic, it is much less invasive.
Despite the advantages, however, most procedures done worldwide have failed or enjoyed only brief success.
Recently, doctors began to suspect the powerful steroids in anti-rejection drugs, which are used to keep the body’s immune system from killing the newly transplanted cells, might be damaging the islets.
The Canadian study, in which all eight patients continue to be symptom-free and insulin-independent, some for more than a year, was the first to use newer steroid-free anti-rejection drugs.
The success seems to suggest doctors have solved the mystery of why past transplants failed.
The University study will use some of these new drug protocols, which, so far, have produced only minor, treatable mouth sores in the eight Canadian patients.
“It should be more successful,” Sutherland said. “We have better anti-rejection drugs.”
Sutherland added that they will have a sense of the cells’ durability one year after the transplant.
“If most are insulin-independent at one year, the grafts are durable.”
While Sutherland is excited about the potential of this procedure, he cautioned it won’t be considered a cure until patients no longer need anti-rejection drugs.
According to the American Diabetes Association, there are about 15.7 million people in the country who suffer from diabetes in one of its two forms. Type 2, also known as adult-onset diabetes, makes up the majority of these, accounting for nearly 15 million.
While Type 2 is less severe and sometimes may be controlled by diet without the need for insulin, both forms of diabetes take their toll on the body.
In addition to causing nearly 200,000 deaths a year, the ADA reports that diabetes is a leading cause of kidney failure, blindness, amputations and can cause a significant level of heart attacks and strokes.
Dawn Halverson, director of development for the University’s diabetes institute and a Type 1 diabetic, said the institute is where the Canadian doctors learned many of the methods they used for their study.
“It’s extremely hopeful,” she said. “The goal is to eliminate diabetes as a disease. The ups and downs of blood glucose really take a toll on your ability to exploit your potential.
“You can’t give the best you have to give to your job, your life, whatever, if this disease poses such a burden on you as a human being.”

Justin Costley covers the Medical School and welcomes comments at [email protected] He can also be reached at (612) 627-4070 x3231.