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Juvenile Diabetes

The Study And Results

By Haleh V. Samiei

Pancreatic cell transplant may aid juvenile diabetes patients.

Previous attempts to transplant insulin-producing pancreatic islet cells to treat diabetes have not been very successful. Researchers in Canada investigated new approaches in preparing the islet cells and preventing rejection when they are transplanted. The researchers collected islet cells from two dead organ donors and injected the cells into a vein in the liver of seven patients who had suffered from juvenile diabetes for decades. Unlike in previous studies, the donor cells were not cultured for several days before the transplantation. The researchers prevented rejection of the transplanted cells by suppressing the patients' immune system with a new combination of drugs, including tacrolimus (Prograf), sirolimus (Rapamune) and daclizumab (Zenapax). Steroids were used in previous transplants. Following one to three transplant procedures, all patients could maintain their blood sugar levels without regular insulin injections. Almost a year later, the transplanted islets still supplied the necessary insulin for the patients, who no longer experienced symptoms such as dangerously low blood sugar levels.

What's New

The researchers used new procedures to prepare and transplant the pancreatic cells. They also used less toxic chemicals to suppress the immune system.

Caveats

Suppression of the immune system would make recipients more susceptible to infections and cancer. To be successful, this procedure may require donations from several people so that there are enough pancreatic cells to be transplanted. The results need to be verified in a larger number of people.

Bottom Line

People with juvenile diabetes may be able to stop insulin injections if they receive a transplant of pancreatic islet cells.

Find This Study

July 27 issue of the New England Journal of Medicine; abstract published early online at http://www.nejm.org.

This article posted on June 22, 2000.