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University of Cincinnati Academic Health Center
Publish Date: 11/27/01
Media Contact: AHC Public Relations, (513) 558-4553
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Islet Transplant Offers New Hope for Diabetes

Cincinnati--Physicians successfully performed the region's first islet transplant on Friday, Nov. 16 at The University Hospital, an affiliate of the University of Cincinnati Medical Center. The UC Islet Transplant Program is one of only five programs to perform a human islet transplant in the United States this year. This revolutionary new procedure provides a less invasive alternative to pancreas transplantation to treat Type I diabetes. The patient, a 42-year-old woman from Otway, Ohio, was released from the hospital less than 24 hours after receiving her islet transplant.

Islet separation and perfusion was performed by Horacio Rilo, MD, associate professor of surgery and pediatrics and director of the Cellular Transplant Program, and his cellular transplantation team. The islets were injected into the recipient in an operation performed by Michael Hanaway, MD, assistant professor of surgery, and E. Steve Woodle, MD, professor of surgery and director of the Division of Transplantation.

"We are extremely excited about the results of our first islet transplant, and we look forward to helping many Type I diabetics in this area," Rilo said. "This new procedure will bring major lifestyle changes for Type I diabetics who are accustomed to several painful insulin injections and finger-sticks to check their blood glucose each day. Although patients who undergo a successful islet cell transplant will need to take daily anti-rejection drugs, they will experience an enhanced quality of life."

Islets are insulin-producing cell clusters found within the pancreas (about 1 million islets are present in a normal adult pancreas). To perform an islet transplant, islets are isolated from a donor pancreas, purified, and then injected into the recipient through a small abdominal vein. The islets lodge in the liver where they reside and begin producing life-sustaining insulin. To protect against rejection, transplanted patients will take a combination of new, potent anti-rejection drugs for the remainder of their lives. The procedure requires a one-hour operation, a two-inch abdominal incision, and less than a 24-hour hospital stay.

Resurgent interest in islet transplantation has been generated by physicians at the University of Edmonton, Canada, who recently showed high success rates in a recent series of 20 islet transplant recipients. Details of their efforts were documented in the July 27, 2000 edition of the New England Journal of Medicine. Thirteen of the 15 islet transplant patients in this series are now free from taking daily insulin injections. More recent reports from the Edmonton group indicate the islets continue to function well two years later.

Diabetes, the fourth leading cause of death in the U.S., is a disease caused by the loss of the body's ability to control glucose (sugar) levels. Type I diabetes is caused by the death of insulin-producing beta cells in the islets of Langerhans located in the pancreas. Exposure to high glucose levels over several years can lead to vascular disease, coronary heart disease, kidney disease, damage to the eyes and nerves, and limb amputation. In the past, treatment for Type I diabetes has been confined to daily insulin injections or kidney-pancreas transplants as life-saving methods to restore pancreas function.

According to Woodle, "Pancreas transplant procedures are now very successful, but they are major procedures. Islet transplants require a much smaller operation and less than a 24-hour hospital stay."

"The patient is doing extremely well. She is back at home and resting comfortably. We are staying in contact with her on a daily basis to assure that her recovery continues as it should," said Samirah Brown, RN, BSN, CCTC, pancreas and islet transplant coordinator.

"Islet transplantation provides an exciting means for treating many patients who are not candidates for whole-organ pancreas transplantation," said Ram Peddi, M.D., associate professor of medicine and medical director of the Islet Transplantation Program. "This is truly an exciting day for the University of Cincinnati."

"Pancreas islet transplantation is another important reason for people in this community to 'donate life' to others," said Hanaway, medical director of the organ procurement LifeCenter, and surgical director of the Islet Transplantation Program. "We are excited about the opportunity to help provide this innovative new treatment for diabetes."

"We are very proud to be the first in Ohio to offer this cutting-edge treatment for a disease that afflicts so many of our citizens," said Jeffrey B. Matthews, MD, Christian R.Holmes professor of surgery and chairman of the Department of Surgery. "This innovative treatment developed and performed by members of the Department of Surgery signals our commitment to carry new treatment modalities from the bench to the bedside through a synergistic combination of bioengineering and surgical techniques. The Cincinnati community can look forward to other such treatment innovations in the near future."

"The University Hospital is extremely proud of this achievement. The hospital staff, surgeons and physicians have been critical in the development and implementation of this innovative and life-altering procedure. We stay vigilant and committed to improving the quality of life and providing the best of care for our fellow citizens of Greater Cincinnati," said Elliot Cohen, senior vice president, The University Hospital.



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