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Total Pancreatectomy Islet Cell Transplant for Type 1 Diabetes

written by: Bobby Mathew • edited by: lrohner • updated: 2/13/2011

Is there a cure for type 1 diabetes? A total pancreatectomy islet cell transplant works in theory. Yet why are so few of these procedures performed?

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    A total pancreatectomy islet cell transplant is a procedure that is still in the experimental stages. It is a surgical process in which islets are taken from a deceased donor's pancreas, purified, processed, then transferred to a patient with Type 1 Diabetes. Once implanted, the islet cells produce insulin. This method is a means to allow type 1 diabetics to live free of insulin dependency.

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    Details About the Procedure

    The islet cells of the pancreas are very fragile. This is why they are extracted from the donor shortly after death. A special enzyme is used to extract the islet cells. Typically, patients receive about 10,000 islet cells per kilogram of body weight. To be free from the use of insulin, recipients often require islet cells from two donors, though this is not the case for everyone that has the procedure performed on them.

    Once the islet cells are extracted using a special enzyme, a radiologist will usually go to work to transplant the cells into the patient. The radiologist will use ultrasound and x-rays to guide a small plastic tube through the upper abdomen and into the recipients liver. The islet cells will then be infused though this small plastic tube. Depending on the circumstances, an anesthesiologist will administer either local or general anesthesia to the patient.

    At this point in the total pancreatectomy islet cell transplant, it is up to the body to do most of the work. Transplanted islet cells should begin to release insulin soon after the transplant is completed. However, full islet function will take time and insulin must be administered until that happens. The patients doctor will often order many blood sugar tests to make sure that the islet cells eventually become fully functional.

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    Benefits and Drawbacks

    Every surgical procedure has its benefits and drawbacks, and a total pancreatectomy islet cell transplant is no exception. The benefits of this procedure is that patients can control blood sugar and prevent or delay its complications. This means that patients will have less of a chance of getting kidney disease, eye damage, nerve damage and heart disease.

    The risk of this type of procedure includes bleeding and blood clots, which are common in nearly any surgical procedure. However, rejection is a serious problem in many transplants. The immune system is designed to destroy materials that are foreign to the body. A donor's islet cells may be understood to be foreign by a recipient's body. As a result, the newly implanted cells could be destroyed. To avoid this, patients who undergo this procedure may have to take immunosuppressants. These immunosuppressants come with their own set of side effects.

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    Why Isn't This Procedure More Common?

    Why isn't this procedure more common? This answer is because there is a shortage of islet cells. Although roughly 7,000 deceased donors are available in America each year, less than half of them are suitable donors. The fact that two donors are often required for each recipient does not help the situation. However, scientists are currently looking for various ways to solve this problem.