Medical science has taken a leap forward with the advances made in diabetes treatment through the islet cell transplant procedure.
The procedure is experimental and rare, but the success rates have kept researchers enthused enough to try and fine tune the process. Islet cell transplantation is done on Type I diabetes patients. Read more about diabetes surgery risks.
Why Is An Islet Cell Transplant Helpful?
Type I diabetes occurs because the beta cells in the islets of Langerhans fail to produce insulin resulting in high blood sugar levels or diabetes. Treatment for diabetes through islet cell transplantation involves removing islet cells from the donor and infusing them into the recipient’s body. Once transplanted, they will start producing insulin, stabilizing blood sugar levels in the patient. So, for whom is an islet cell transplant suggested? This article on diabetes diagnosis will help you understand whom islet cell transplantation is actually recommended for.
The Steps Involved In An Islet Cell Transplant
As with all medical procedures and surgeries, some basic preparation would be required before you actually head into surgery. Pre diabetes treatment becomes all the more important considering the risky nature of the islet cell transplantation surgery.
Step #1: Beta cells are harvested in the donor’s pancreas
The first step in an islet cell transplant involves identifying, isolating, and removing the beta cells from the pancreas of the deceased donor. This is not as simple as it sounds as beta cells are rather rare. They account for just 1% of all cells in the pancreas.
Most of the remaining pancreatic cells are involved in the digestive process and only the beta cells produce insulin. In addition to this, the harvesting process may itself damage and destroy a few cells.
Beta cells are obtained using the following procedure:
- The process of isolating the beta cells is started by injecting a mixture of purified enzymes called collagenase into the donor pancreas. This enzyme, which is injected into the pancreatic duct, will cause the organ to distend.
- Once the pancreas expands, it is cut up and removed.
- The pancreas is then placed in a Ricordi chamber, an equipment which is a novel digestive chamber. When digestion takes place, the islet cells are liberated.
- These islet cells are then removed from the surrounding tissues by a process known as purification.
Step #2: Enough donor cells are collected
As stated earlier, beta cells are rather rare. The recipient requires 10,000 islets to correspond to each kilogram of his/her body weight. Sometimes, it may not be possible to get this from one donor pancreas. Therefore, two or more donor organs will have to be harvested to get enough cells for the islet cell transplant procedure.
Step #3: Donor cells are transplanted to the recipient
The process lasts for around an hour and general anesthesia or local anesthesia will be used as per the doctor’s assessment. The patient should be prepared to undergo a repeated transfusion if needed. This is done a few days after the first procedure.
The actual transplant process is as follows:
- The process is not very invasive as it involves the transplant of cells.
A radiologist will place a catheter via the upper abdomen into the portal vein of the liver. The portal vein is a large blood vessel that goes to the liver.
- The islets are the infused slowly into the liver via the catheter. The islets are infused into the recipient’s liver and not the pancreas as the liver is comparatively more accessible. The liver’s accessibility makes the procedure much easier.
- The injected islet cells are taken up via the small blood vessels into the liver. Once they settle down in the liver, the transplantation is completed.
- In cases where local anesthesia cannot be used due to allergic reactions, a surgeon will make a small incision in the upper abdominal area and complete the rest of the steps involved in the transplantation.
What Happens After An Islet Cell Transplant?
Here’s a quick look at how the transplantation actually works:
- The transplanted islets will take some time to settle down and attach themselves to the new blood vessels. Once this is done, they will start producing insulin. This means that the recipient will no longer be a Type 1 diabetic.
- However, it does take some time for the islets to turn fully functional. New blood vessel growth will also take time. During this time, blood sugar levels will be constantly monitored and insulin doses will be given.
Islet cell transplantation does have a good success rate for the first year following the procedure.
Studies indicate that 40 per cent of diabetic patients who underwent the pancreatic transplant procedure for diabetes were insulin-free for one year. But after three years, only 17% of the patients were insulin free. This figure further drops to 10% after five years. Therefore, the islet cell transplant procedure cannot be regarded as a cure for Type 1 diabetes yet.