Diabetes Surgery Risks – What to Watch Out For During Islet Cell Transplants

Diabetes surgery risks are definitely a point to consider while taking up the islet cell transplant procedure for diabetes treatment. Every surgical procedure comes with certain levels of risk, and the same is the case with islet cell transplants.

Islet cell transplants have brought hope to all those who suffer from Type 1 diabetes. This kind of diabetes is caused when the body’s auto-immune system attacks and destroys the beta cells in the Islets of Langerhans. The beta cells produce insulin and when they are destroyed, insulin production in the body grinds to a halt.

After the diabetes diagnosis is confirmed and surgery is decided upon as the necessary treatment option, the patient is prepped physically and mentally as part of pre diabetes treatment. The islet cell transplant procedure itself involves the introduction of islet cells from a donor pancreas into a Type 1 diabetic patient. These donor cells will then start producing insulin and stabilize the blood sugar levels in the diabetic patient. However the diabetes surgery risks are considerable.

Diabetes Surgery Risks

Due to the effects of immunosuppressant medication, hypertension is one of the diabetes surgery risks

A Look at Some Diabetes Surgery Risks

Here’s a quick look at the dangers involved in the pancreatic transplant procedure.

Diabetes Surgery Risks #1 – The Procedure is Experimental

Islet cell transplant is still considered to be an experimental therapy. As a result cell transplant risks are still quite high. The procedure is carried out only in a few select centers in the United States. The experimental nature of the procedure and the fact that clinical trials are still being conducted means that the diabetes surgery risks may not have been completely understood as yet.

Diabetes Surgery Risks #2 – Immune System Attacks

The procedure involves introducing a ‘foreign substance’ into the body, and islet cells from a donor are injected into the system. The first reaction of the body to such an invasion by a ‘foreign substance’ is to reject it. The auto-immune system will gear itself up to reject the transplanted cells. Thus the risk of rejection is definitely one of the biggest islet cell transplant risks.

Diabetes Surgery Risks #3 – Side Effects Through Immunosuppressant

Since the danger of rejection is very high, the patient is likely to be on immunosuppressive medication for the rest of his life. However there are problems associated with taking these drugs. They are extremely expensive. Not only that they have rather dangerous side effects. These side effects include:

  • Development of ulcers
  • Edema (which is basically the accumulation of fluid)
  • Anemia (which can cause extreme fatigue)
  • Hypertension
  • Diarrhea

More serious side effects include renal failure and the possibility of triggering the growth of cancerous cells in the body. This is because these immunosuppressive drugs do have a certain level of toxicity.

Diabetes Surgery Risks #4 – Damage to the Liver Region

During the procedure the patient will receive around 10,000 islet equivalents for each kilogram of his body weight.  The islets are introduced into the portal vein of the liver from where they are infused with a catheter into the liver itself. One of the cell transplant risks involves damage to the area around the liver. This could be:

  • Bleeding near the liver
  • Infection in the liver vein
  • Clotting
  • Hemorrhage in the inter-abdomen area
  • Deterioration of liver functions
  • Portal vein thrombosis

Diabetes Surgery Risks #5 – Lack of a Permanent Cure

Given the experimental nature of the procedure, studies also indicate that the transplanted cells may just stop working eventually. According to published reports, patients who undergo the procedure do remain insulin free for nearly a year. But there are indications that this is not permanent and insulin dependency will slowly increase as time passes. Therefore, islet cell transplant cannot be regarded as a permanent cure for Type I diabetes yet. The treatment is not widespread enough, nor has it been done for long enough to evaluate long term risks. Patients who undergo the procedure should understand that the therapy has been not conducted long enough to analyze its long term impact. Some of the concerns are:

  • Doubts on the long term impact of introducing the cells in the liver.
  • Concern over whether there will be a consequent rise in the portal pressure.
  • Questions have been raised over whether the procedure will affect the patient’s ability to have future transplants in other organs. This is because the islet cell recipient may be sensitized against donor tissue.

Given the diabetes surgery risks involved, it is definitely too early to declare that the procedure is a cure for diabetes. But neither can the success rate of the procedure be brushed aside. Patients who undergo the procedure do become less dependent on insulin. Given these positive results, it is little surprise that there is almost continuous research going on in the field.

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