Transplantations for Type 1 Diabetes

Type 1 diabetes occurs when the β cells of the pancreas are destroyed, usually by your own immune system. This prevents you from producing and releasing insulin, a vital hormone, which prompts your body to store glucose. The main type of treatment is insulin replacement with a synthetic form to compensate for your bodies lack of production, however there are two main types of transplant that may be available to you.

Pancreas Transplant from a Donor

Recently, it has proved possible to transplant the pancreas from a dead donor into someone who suffers from type 1 diabetes. This has proved best when the pancreas is transplanted at the same time as a kidney, if you suffer from end stage renal disease. If you decide to have either a pancreas or double organ transplant, there is a 3 in 4 chance that you will survive over 10 years from the operation.

The main advantage to having an organ transplant is that it can cure your diabetes, meaning hopefully you would no longer require insulin replacement therapy. Studies also suggest that the transplant can also help to prevent and even reverse neuropathy. However transplantation is not for everyone, the operation is long and can be quite painful in the recovery period. You would also be required to take immunosuppressive drugs for the rest of your life to prevent your body from rejecting the pancreas. This may cause you to become ill more frequently than before the transplant, as the drugs damp down your immune system.

Islet-cell Transplant

The second type of transplant is a so called islet-cell transplant and is newer and more complex. The first type of islet cell transplant involves harvesting β cells from a donor pancreas and infusing them into a major blood vessel in your liver. The hope is that they will stick into the small capillary network of blood vessels and begin to produce insulin which then compensates for your bodies lack of insulin production. Recent advances in this technique are now being put through scientific trials to see how well it works. This new technique is called the Edmonton procedure and involves using islet cells from multiple donor pancreases, which are then infused into your liver, after you have been given antibiotics and a number of essential vitamins. To have a clinical effect, you will need to have this procedure repeated a further 2 to 3 times over a few months. You will also need to take immunosuppressive drugs for the rest of your life, again to help prevent your body from rejecting the cells.

The major disadvantage to having an islet cell transplant is that more than one pancreas is needed to complete the operation. On average 2 to 3 are needed every time the procedure is done, which is not feasible currently, as there aren’t enough organs being donated. Some studies have investigated using islet cells from animals such as pigs to be used for transplantation. These studies have shown that this could be a useful way to overcome the shortage of pancreatic islet cells.

There has been some scientific interest in trying to overcome using animal sources by growing islet cells from stem cells. Unfortunately this is still at the theoretical stage.

If you are eligible for a transplant, your doctor will be able to advise you as to what is the best for you. Due to the disadvantages of the islet cell transplant, it is likely that a whole organ transplant is the best possible option.

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